Routine inspection·January 19, 2024

Licensing Program Analyst (LPA) Anna Bueno made an unannounced visit to conduct a required annual inspection. LPA was met by care provider Pat Salinas who was informed of the purpose of the visit. SAlinas phoned Licensee Amparo Liwanag and spoke with LPA. LPA informed Licensee of the reason for LPA's visit. LPA and Salinas toured the interior and exterior of the facility. The facility is licensed for 6 non-ambulatory residents with a hospice waiver for three (3). Physical Plant and Safety of Environment/Operational Requirements: LPA observed the facility to be clean and in good repair. The home is maintained at a comfortable temperature for the residents. Lighting is sufficient for safety and comfort. Water temperature was measured and found to be comfortable for residents. Laundry facilities and locked cabinets were present for storing laundry soap and other chemicals. Fire extinguishers are charged. All outdoor and indoor passageways and ramps are free of obstruction. The facility does not have bodies of water. A locked area is provided for medications and sharp objects. There is a working telephone at this location. The LIC 610E, emergency disaster plan is maintained. The facility is maintained in conformity with the regulations adopted by the state fire marshal. Personnel Records/Training/and Staffing: LPA reviewed employee records for fingerprint clearance, personnel/job application, health screening and TB test results, criminal record statement, employee rights, training verification, and current administrator certification. LPA did not observe training on needs for residents receiving hospice services. This poses a potential health and safety concern for clients in care. Resident Records/Incident Reports/Personal Rights/Residents with Special Needs/Incidental Medical and Dental: LPA reviewed resident records and found that they contained records including, admission agreement, medical assessment and TB test results, consent forms, identification and emergency information, appraisal needs and service plans, safeguard for personal property/valuables, and personal rights notification. The facility is meeting documentation requirements. Resident Rights are posted in the facility and a copy is signed on file. During the visit, LPA and staff observed Resident 1 (R1) non-prescription PRN medication without a physician's order. This poses a potential health and safety risk to clients in care. Food Service: LPA Bueno was present during lunch time. LPA observed the meal is adequate to meet the nutritional needs of the residents. Food supply meets the requirement of one week supply of nonperishable and 2-day supply of perishables food on hand. The kitchen area is kept clean. LPA Bueno made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. The facility has not exceeded its capacity limitation and the structure remains unchanged according to the approved floor plan. Smoke detectors were tested by staff while LPA Bueno tested the hallway carbon monoxide detector. All units were found to be operational. During today's visit, LPA found Resident 2 (R2) with full bed rails and was not receiving any home health or hospice services. LPA was also informed that there is no documentation for disaster drills available. These pose potential health and safety risks to clients in care. Based on the information received during this visit today, the following deficiencies are being cited per Title 22, Division 6 of The California Code of Regulations. Refer to LIC 809D for cited deficiencies. This report and LIC 809D were reviewed by phone wiht Licensee Liwanag and a copy provided to the facility representative. Appeal Rights were also provided at the time of the exit interview.