Post-licensing visit·November 22, 2024

Licensing Program Analysts (LPAs) Amy Rodgers and Angelica Boyles conducted an unannounced postlicensing visit to the facility today. The facility is located on a multi-use property which includes three other licensed facilities. LPAs entered common use ground and knocked on the facility’s door. LPAs entered the facility and after 10 minutes an adjacent licensed facility staff member, S1 came to greet LPAs. House manager Jamily Hallak arrived shortly after and explained that most visitors sign in at an adjacent licensed facility and then proceed to an occupied building. Licensee Maria Williams arrived later to discuss the postlicensing visit findings. LPAs toured the facility in addition to conducting a general overall inspection, which included, but was not limited to, the following: facility physical plant, food service, medication management, records review, and facility administration. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, and meetings.. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. There were no toxic chemicals/poisons accessible to clients. Medications were labeled and stored in a locked area. No pools or bodies of water on the premises. Per staff, no firearms or ammunition are kept at the facility. Carbon monoxide detector, fire extinguisher, and facility telephone were present. [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC 809] During today's visit, LPAs walked through the facility and interacted with the resident in care (R1). The other resident (R2) is currently at a skilled nursing facility. LPAs also conducted a file review for the residents. Staff interviews revealed that there is not staff assigned to the facility at all times nor is there a staff schedule reflecting staff being present at the facility. Interview with the licensee state staff from the sister facilities Acorn Oaks Manor I, II, and III check on residents. Interview with staff #3 (S3) state that the sister facilities Acorn Oaks Manor I, II, and III check on residents anywhere from every 20 minutes to 2 hours. Residents do maintain call buttons that will alert staff in the adjunct facility of their need of assistance when staff are not present in the home. However, LPA Rodgers conducted an interview with R1 in which he was unable to identify the location of his call button or that a call button was present. A deficiency is being cited due to absence of supervision. The deficiency is cited in accordance with California Code of Regulations, Title 22, Division 6, Chapter 8 and noted on the attached LIC 9099-D. An immediate civil penalty in the amount of $500 issued at today's visit. LPAs spoke to Licensee Maria Williams and reviewed report, civil penalties and POC. An exit interview was conducted with Licensee Maria Williams whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.