Routine inspection·October 16, 2024

On October 16, 2024, Licensing Program Analyst (LPA), Venus Mixson, made an unannounced visit to the facility for the purpose of conducting the Required Annual inspection, and met with Norisa Domilos, the Administrator. LPA introduced herself and stated the purpose for the visit. The facility file review was conducted at the Regional Office and additional records were requested and reviewed on site. PHYSICAL PLANT : Facility is located at 1930 Monte Vista Drive, Vista, CA. 92084, and the land line phone number is (760) 630-6381 and is operable. Facility is licensed for six Elderly Adults for a (740) facility type and is operating at one which is within the conditions and limitations of the license. Outdoor and indoor passageways are free of obstruction and debris at the time of this visit. There were no pools or bodies of water observed on the property at this time. According to staff, there are no known weapons kept in the home. Disinfectants, cleaning solutions, and poisons were inaccessible to resident in care. The facility temperature was within in regulations for this time of day and the season, and there was sufficient lighting throughout the facility. Hot Water temperature: Was tested and found to be within regulations. LPA Mixson observed the Fire extinguisher located at the front door area, located off the kitchen, and has proper inspection tag. Last inspected by Fire Tech. The smoke and carbon monoxide alarms were in the green. The interior and exterior areas of the home were observed to be clean and organized. FOOD SERVICE : There was a variety of food types which were sealed and stored in a safe and healthful manner. Food supply of nonperishable and perishable foods was sufficient for the number of residents in care. The kitchen was observed to be clean, neat, and orderly. Additionally, kitchen was free of orders and any signs of pest. LPA observed the required two-day supply of perishable and seven-day supply of non-perishable food items. Care & Supervision / Administration: Adequate staff are present for the supervision of resident in care. Floor plans, telephone numbers and personal rights were found posted in the facility. The listed administrator possesses an administrator’s certificate with an expiration date of 11/10/2023, and renewal application and funds were sent sometime in September of 2023. Records Reviewed and Resident/Staff Files: LPA reviewed two staff files and reviewed the facility's staff schedule. The staff file reviewed has criminal clearance and updated training's along with First Aid and CPR Certification. One resident file was reviewed and possessed required paperwork, except for the emergency identification information and current doctors’ appointments and weight records, obtained on the Physicians report LIC 602. MEDICATION : Medications were reviewed for one resident in care. Medications were labeled and maintained in compliance with label instructions and State and Federal law. Medications were observed to be safe, locked, and inaccessible to resident in care. Medications and medication documentation was observed to be well organized and monitored. Disaster preparedness: LPA Mixson reviewed the facility's emergency and disaster plan. Additionally, the disaster training binder and other training's were reviewed. LPA observed the last fire drill met the department standards and was conducted on 10/01/2024 and was conducted by Administrator. Infection Control: LPA Mixson observed the hand washing stations in the facility restrooms. LPA observed PPE equipment and cleaning supplies to do regular cleaning of the facility. LPA reviewed the facility's infection control plan and found required infection control measures. There were TA deficiencies observed for missing forms in one of one residents file and TA per Title 22, Division 6 of the California Code of Regulations at this time. An exit interview was conducted where a copy of this report was discussed and given to Administrator, Norisa Domilos.