Routine inspection·November 3, 2023

Licensing Program Analysts (LPA) Amy Rodgers, made an unannounced visit to conduct the required One-Year Inspection to ensure substantial compliance with Title 22 regulations. LPA Rodgers was granted entry into the facility by Executive Director, Jared Green, after identifying herself and stating the purpose of the inspection. This facility serves sixty-eight (68) elderly residents; age 60 and above; fourty-one (41) may be non-ambulatory. There is also a Hospice care waiver for ten (10). Facility is equipped with a secured perimeter in the memory care units. This is a muti-unit property.. LPA was accompanied by the Executive Director, Green during a tour of the facility. A tour of the facility was conducted of the cottages and the two (2) memory care units in the community and included a sample of resident units, the dining area, recreation rooms, and food storage areas. Signal systems are in place and operational. PPE supplies are onsite. No bodies of water are on premises. Passageways were free from obstructions. According to Executive Director, Green, there are no weapons and/or ammunition stored on the premises. All doors were operational. Each resident had clean and sufficient bed linens. All extra linens towels, and washcloths are all accessible in rooms or in the locked facility store room. All residents’ rooms were equipped with required furnishings. Lighting was present in the bedrooms. Residents’ bathrooms were observed to be sanitary and operational. Toilets and showers were equipped with grab bars. [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC 809] Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were in working order. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. Facility has a two-day supply of perishable food and a seven-day supply of nonperishable food items. Food supply is replenished frequently by outside vendors. Food was observed to be properly stored and labeled. The food service area was observed to be neat and clean. Food menus and activities schedule were posted. Most chemicals and cleaning supplies were stored in a locked closed room. Centrally stored medications were properly stored and locked on medication carts. Medication logs and medications reviewed were current and medications appear to be administered according to the label instructions. Staff records review verified that all staff records were not complete and compliant. Some direct care staff have First Aid certificates and First Aide/CPR certificates. LPA observed some slip-strips in showers. Resident records reviewed and confirmed compliant. Administrator’s certification is current. LPA conducted a thorough review of In-service training procedures. Facility provides transportation arrangements for persons served who do not have independent arrangements. LPA observed that residents were being treated with dignity by staff, and there were sufficient staff on duty to meet resident’s needs. Deficiency was cited per California Code of Regulations, Title 22 (refer to the attached LIC 809-D page). A Plan of Correction was jointly developed with Executive Director, Green. An exit interview was conducted with Executive Director, Green, to whom copies of this report, the LIC 809-D page, and the Licensee/Appeal Rights (LIC9058 03/22) were provided at the conclusion of the visit.