Routine inspection·February 21, 2024

On February 21, 2024, Licensing Program Analyst(LPA) John Calandra arrived at the facility at 10:15 AM to conduct the Annual-1 year required visit. LPA Calandra met with Margie Valeria, Administrator and explained the purpose of his visit. LPA Calandra toured the physical plant. This is a two story building that consists of 8 bedrooms and 3 bathrooms. Water in all bathrooms was measured between the required 105-120 degrees Fahrenheit. Bathrooms were observed to have the required grab bars and anti-skid mats. Fire extinguishers in the facility were observed to be fully charged and last inspected on October 23, 2023. The facility had the required 7 days of non-perishables and 2 days of perishables on site. No food was expired. The kitchen refrigerators and freezers temperature were within the required range. All bedrooms were sufficiently lit and had the required furniture. The backyard was clear from obstructions. No accessible bodies of water or hazards were observed. The facility does not handle cash resources. The facility was maintained at a comfortable temperature of 70 degrees Fahrenheit. All knives, sharp objects, soaps, detergents, and medications were observed to be locked and in-accessible to persons in care. LPA Calandra reviewed 5 resident files and 5 staff files. All staff files were observed to be complete. R1's file was missing the Annual Needs and Services Plan. A review of Centrally stored medications indicated that medications for residents were properly labeled with instructions on dosage and times of day and matched the Centrally Stored Medication records kept at the facility. Technical Violations(TV) were provided for failing to conduct an emergency drill at least quarterly per shift and not including in their plan of operation information about accepting/retaining residents with dementia. During today's visit, the facility was cited for not including an appraisal of a resident's individual needs and service in comparison with the admission criteria. The following documents were requested during today's visit: -Liability Insurance -Updated LIC 500 -Updated LIC 400 -Facility sketch showing evacuation routes -Updated designation of facility responsibility-LIC 308 Deficiencies of the California Code of Regulations, Title 22 are cited on the LIC 809-D. Failure to correct the deficiencies may result in civil penalties. This report was reviewed with Margie Valeria, Administrator, and a copy along with appeal rights left at the facility.