Routine inspection·September 11, 2023

On 09/11/23, Licensing Program Analyst (LPA) Michelle Echeverria arrived unannounced to conduct the required annual visit to the facility. LPA met with Caregiver, Blanca Cabrera, and introduced self and stated purpose of the visit. LPA was informed that there are currently 6 residents in care. The facility has 6 bedrooms, 3 bathrooms, kitchen, dining area, living room, office, attached garage, and backyard. LPA completed a walk through of facility and review of records. Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 75 degrees fahrenheit. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, chairs and sufficient lighting. LPA inspected resident bathrooms; bathrooms were clean and appliances were found functional. Water temperatures tested at 108.3 degrees fahrenheit. The facility is equipped with operational smoke detectors, carbon monoxide alarms, fire extinguishers and emergency kit. Posters such as; the personal rights, ombudsman and emergency disaster plans were posted in a common area. LPA observed the emergency disaster plan not reviewed since April 2022. Deficiency issued. LPA also observed cleaning supplies, toxins, sharps, and other dangerous items locked in cabinets made inaccessible to residents. There was a designated locked storage space for resident/staff files and medication. Food Service : Non-perishable and perishable food supply is not sufficient for number of residents in care. LPA observed lots of expired perishable and nonperishable food. Deficiency issued. Dishes, cups, and utensils were also stored properly. Yards/Outside: One shaded patio, a side gate with a locked door knob on the right side of the house that leads into the backyard, a shed and industrial container used as storage. Deficiency issued for locked gate due to not notifying the licensing agency. All outdoor pathways were free of obstructions. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. Not all staff members working in the facility have criminal record clearance through the department. Deficiency issued with civil penalty. Record Review: LPA reviewed 4 resident files for admission agreements, updated physician reports, and needs and services plans. LPA observed an incomplete resident file for resident 1 (R1). Deficiency issued. LPA also reviewed administrator's and 4 staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings. LPA observed incomplete personnel records for (S1) (S2) and (S3). Deficiency issued. LPA also observed missing trainings for first aid/cpr and medication for staff. Deficiency issued. LPA observed that the facility did not have an Infection Control Plan. Deficiency issued. Eight deficiencies and one civil penalty were cited during this visit. An exit interview was conducted where this report LIC809, LIC809C, LIC809D, LIC421BG and appeal rights were discussed and copies were provided to the Administrator Rachel Riley who later arrived.