Routine inspection·July 25, 2025

Licensing Program Analyst(LPA) Noel Wolf Petersen arrived unannounced to conduct an annual visit on 7/25/2025 at 12:00pm, The LPA asked the staff gertrude to call the administrator so the purpose of the visit could be explained. Magnolia care home 1 is a 6 bed facility for the elderly with 5 residents in the current census. 2 ambulatory, 3 nonambulatory. 1 has dementia. 2 are on hospice. 4 have diabedes(controlled via PO medication). Physical Plant was inspected, including but not limited to the kitchen, common areas, client bedrooms, client bathrooms, exteriors, and evacuation routes. The facility is clean, and traffic areas are well lit and unobstructed. the kitchen has adequate lockable storage for sharps and toxics, there is 2 days of perishible/7 days of nonperishable foods. MARs for each of the residents were checked; in 1 of 5 records a psychotropic medication(trazadone) was not documented as given when it was for many days this month. The common areas are clean and have enough space for activities. the bathrooms have hardware in good repair, temperature was measured at 118*F. LPA observed hygine related toxics(hand soaps/shampoos/conditioners/hairsprays) within access to ambulatory dementia client. Client is on 1 to 1 supervison, it is unlikely she would use the bathroom by herself, however she does wander at night. The Licensee is going to store the offensive chemicals locked. The exterior screens are in good repair, plenty of space for activies, no tripping hazards. evacuation route gate is in good repair. Fire extinguisher was last checked 5/19/25. Posters in cluding the facility sketch, administrator cirtificate, facility license, federal work requirements, personal rights, and the ombudsman information are all present and of the correct dimension. Continued on C Page. 5 of 5 Client records were reviewed, the files included but were not limited to the signed admission agreements, physicicians reports, hospice care plans, preadmission apprasials, and emergency contact information. Files were found to be present and up to date. Personal property for 1 of the clients was labled "cloths" with no itemization, personal property for 1 of the clients was missing signtures and numbers regarding some expensive property(television, cellphone, ect). Licensee is going to get the Personal property reinventoried and get signatures from the clients or thier representatives. 3 of 3 Staff records were reviewed, including but not limited to criminal background checks, fingerprinting, cprt/first aid training, and annual continuing trainings. 2 staff do not have an up to date cpr/first aid training on file, 3 staff do not have continuing training with regard to the specific topics within dementia care or the general topics in RCFE care. There is staff on duty with a up to date cpr/first aid at the time of this report. Licensee reports at least 1 staff having an up to date cpr/first aid training that has not yet been added to the file. Licensee provided the training would be completed as soon as possible and continued annually into the future. Administrator records were reviewed, including but not limited to the program design, sample admission agreement, liability insurance, evacuation plan, administrator certificate, facility license, shift logs, staff roster, and client roster. Documents are present and up to date. Client interviews, 2 clients were interviewed. concerns related to the high salt content of the meals were raised. Staff interviews, 2 staff were interviewed. staff are unfamilar with resident rights and abuse reporting requirements. Per title 22, Citations, Technical Violations, and Technical Advisories were given as a result of this visit. LPA is requesting a updated 610E, sent to the LPA(noel.wolfpetersen@dss.ca.gov) by 8/1/25 An exit interview was conducted, the copy of the report was read and given to the staff.