Routine inspection·November 19, 2024

On 11/19/2024, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to conduct an annual visit. LPA met with Staff Members (SM), Everly R. Estella and Cathleen Maghinay and explained the purpose of the visit. LPA asked the SM Estella and SM Magaimay to call the Facility Designated Administrator (FDA), Maybelyn Ugale to inform them that CCL was present. Shortly after, LPA Pascua met with Current census was 3. A brief interview with SM Estella and Magaimay were conducted. LPA reviewed 3 resident files. It was observed that 2 out 3 residents did not have current physicians reports or needs and services plans on file. LPA reviewed 2 staff files. 2 out 2 staff files did not have a First Aid/CPR certificate on file. A tour of the kitchen was conducted. LPA observed a sufficient amount of 2 day perishable and 7 day non-perishable food supply at this time. Knives were locked and made inaccessible in a separate closet away from the kitchen at this time. A fire extinguisher located in the kitchen was observed to be last serviced on 05/28/2024 by Armor Fire Inc and is in compliance at this time. Smoke detectors and carbon monoxide was observed to be in good repair. Medication was observed to be in a locked cabinet near the kitchen. Along with the administrator, LPA reviewed and compared resident medication to medication dispensing logs. A tour of 3 resident bedrooms were conducted. LPA observed that in 2 out 3 resident bedrooms did not have a chest of drawers sufficient to meet the resident's needs. A tour of a staff bedroom was also conducted. A tour of 2 resident bathrooms were conducted. Hot water temperature was taken to ensure that it was dispensed at the correct temperature at this time. LPA osberved water damage on the corner of the baseboard near the shower. Additionally, scuffs from the resident's belongings were along the walls. A linen closet was identified. Linen was observed to be in sufficient for residents in care. A tour of the garage was conducted. Washer and dryer were identified. Toxins, laundry detergent and other cleaning supplies were observed to be locked and made inaccessible. A tour of the yard was conducted. Perimeter fence and gates were observed to be in good repair with no hazards present. The following forms were requested to be submitted: -LIC 500 -LIC 408 -LIC 610e As a result of this visit, the following deficiencies were observed and cited on the following LIC 809-D pursuant to Title 22 Rules and Regulations, Health and Safety Code. An exit interview was conducted. A copy of the 809, 809-C, 809-D, and appeal rights were printed and a copy was given to the facility designated Administrator, Maybelyn Magsayo-Ugale. The licensee was informed that a failure to correct any deficiencies by plan of correction due date(s) may result in civil penalties.