Routine inspection·May 10, 2024

Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a required annual inspection. LPA met with Aniko Barlow, Administrator, and discussed the purpose of the visit. The facility is a Residential Care Facility for the Elderly (RCFE) with a license capacity of (5) and a current census of (3) residents in care. LPA conducted an overall inspection of the facility, which included, but was not limited to, the following: Physical Plant/Environment: Indoor passageways are free of obstruction. The facility has no swimming pools or similar bodies of water. Outdoor shaded area is sufficient for resident activities and is enclosed with a self-latching gate. The facility has sufficient lighting and is maintained at a comfortable temperature. Resident’s showers, toilets, and hand washing areas were operating in a safe and sanitary condition. The hot water temperature in residents' bathrooms measured 111- and 115-degrees F. Four (4) resident’s bedrooms had beds, bed linen, chairs, nightstands, and sufficient storage space and lighting. The facility had operating carbon monoxide/fire alarms, laundry equipment, and telephone service. The facility has sufficient bed linen, towels, and personal hygiene items for residents. The facility has posted in a common area, Community Care Licensing complaint poster, Ombudsman poster, facility license, and disaster evacuation plan. Sharps, disinfectants, and cleaning solutions were kept in a locked cabinet. Care & Supervision : Facility has 24-hour, 7 days a week care staff. Facility staff has current CPR/first aid training. Medical Related Services : Resident’s medications are labeled and centrally stored in a locked cabinet. The facility has a complete first aid kit with manual. Food Service: The facility kitchen and dining areas are maintained clean. The facility has sufficient non-perishable and perishable food supply for residents in care. The facility has a menu posted in the kitchen area. Record Review: Three (3) staff files reviewed were observed to be complete. Three (3) resident files reviewed were observed to be complete. The facility has current liability insurance, emergency disaster plan and infection control plan on file for review. Based on observations and record review, the following deficiencies are being cited per Title 22, of The California Code of Regulations and per Health and Safety Code: The Licensee did not maintain a current quarterly emergency drill on file. The last fire drill conducted was on 8/4/23. The Licensee did not maintain the backyard free observation as overgrown scrubs/foliage blocked passageway. The Licensee did not maintain an approved Hospice waiver increase on file. The facility has an approved Hospice waiver for two (2) and currently has three (3) residents receiving Hospice Care. During the visit, LPA contacted the regional office and no request was found for a Hospice waiver increase. This report and LIC809-D was reviewed with the Administrator and a copies with Appeal Rights was provided to the Administrator and the conclusion of the visit.