Routine inspection·August 13, 2024

On 8/13/2024, Licensing Program Analysts (LPA's) Tobola & Jian conducted an unannounced Annual Required – 1 yr. inspection for this facility and was greeted by Caregiver Staff, Maria "Tess" Alday. Assistant Administrator, Matt Montilla was contacted and arrived later in the visit. The facility currently provides care for 11 residents, 1 of which are receiving hospice services and some of which with a diagnosis of dementia. LPA's continued with a tour of the facility with staff, facility found to be clean and at a comfortable temperature with all exits free from obstruction. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguisher was found to be last charged on 10/6/2023. Carbon monoxide detectors found in both upstairs and downstairs hallways, were tested and found to be functioning. Smoke detectors are inspected by local fire inspection agency with last inspection dated 1/26/2024. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations, with food stored in the kitchen refrigerator found to have appropriate coverings, enough for residents in care. LPA's however, observed multiple items including milk, fruits and eggs expired or with mold. Medications were observed unsecured in kitchen refrigerator, accessible to residents. Cleaning supplies and other toxins are safely stored in locked cabinets in the, bathroom, garage and under kitchen sinks, all of which were secured upon inspection. There was a supply of hygiene products and paper products available for residents. All resident’s bedrooms have lighting & appropriate furnishings and bedding items. Water measured at faucets accessible to residents measured between 106.7 and 109.4 degrees F and within regulation. Residents that were awake during the inspection were observed interacting with staff in the common area, or in their bedroom resting. The facility encourages regular family visits and utilizes common and outdoor space for resident exercise and mobility. The outdoor patio is equipped with shade with sufficient space for resident use. Continued onto LIC809-C During inspection LPA's observed 2 auditory alarms in resident bedrooms inoperable, and is required for residents with dementia. LPA conducted a sample file review for 4 residents and found all items to be in order. LPA's provided technical support on facility to provide additional information on resident Needs & Service Plans. Technical Violation. Upon a sample review of staff files, LPA's found all staff to have 1st aid and CPR and annual training up to date. Lastly, during a spot medication check, LPA's found that 1 out of 1 resident was missing a single dose of prescribed medication. In addition, facility was found to have pre-poured medication 2 days prior and not stored in original container. During inspection, LPA's observed resident (R1) with a bedridden status but had recently graduated from hospice services. A physician's assessment for R1 was conducted today 8/13/2024 with pending physician's report. LPA to follow up on R1's ambulatory status and determine findings at a later date. Danilo Montanilla's Administrator Certificate 7035451740 is currently active through 11/26/2024. LPA requested the following documents be sent to CCL by COB 8/27/2024: LIC 308 Designated Facility Responsibility LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan LIC 9020 Register of Facility Client’s/Resident’s Liability Insurance Pest Control Receipt Deficiency cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12-month period may result in civil penalties.