Routine inspection·April 26, 2023

Licensing Program Analyst (LPA) Chavez made an unannounced 1-year required annual visit to the facility above. LPA met with Joel Wobrock, Licensee/Administrator, and Deborah Cole, Back-up Administrator, and explained the purpose of the visit. LPA requested a staff roster, a resident roster, emergency and disaster plan, and documentation of quarterly emergency drills. LPA toured the facility with back-up administrator and the following was noted: LPA observed the license posted, licensing reports, personal rights, non-discrimination notice, LTCO poster, CDSS Complaint Poster, Bill of Rights and Right to Residential Council . The facility has 5 bedrooms and 4 bathrooms, a kitchen, dining room/living room, courtyard in the back of the facility, and garage. Medications are kept in a locked cabinet in the garage. Physical plant was check for cleanliness and condition. Walls, windows, ceilings, floors and floor coverings, and doors were checked, and all were in good condition. The facility maintains a comfortable temperature. The facility provides a working telephone for resident use. Dual smoke and carbon monoxide detectors are hard wired and were tested and operational. Fire extinguishers located in the garage and hall near garage were last inspected 04/07/23 and 4/26/23 and are charged in the green. There are no issues with Fire Clearance. Living and dining room furniture were also checked for functionality and condition. The living room is clean, safe and sanitary along with the dining room. Courtyard of the facility has outdoor furniture, with a covered shaded area for residents. There are no bodies of water on the premises. There is plenty of outdoor lighting available for the safety of the residents. External gates (3) had latches/locks on the exterior, making it difficult for residents to open. Technical violation given. Kitchen was sufficiently stocked with two-day perishable and seven-day non-perishables. The menu was posted for review. Snacks and beverages are available for residents in the facility when they want. Foods are properly wrapped and stored. Food storage and preparation areas are clean and inaccessible to pests. Continued on 809-C. Resident rooms have beds with sheets, pillowcase, mattress pad, and blankets which are in good condition. There is at least one chair, nightstand and enough lighting for each resident. There is enough linen available to change weekly or more, if need. Bathrooms were checked for cleanliness and proper operation. The hot water temperature measured between 114 F and 116 F degrees in resident bathrooms. Towels and washcloths are not shared. Residents have a sufficient amount of supplies for personal hygiene. Soap, paper towels and toilet paper are provided by the Licensee. Grab bars are secured in toilet and shower areas. Showers have non-slip bottoms or mats. Resident records were reviewed for requirements and legibility: LPA reviewed 5 residents’ files for current Medical Assessments with TB results, Current Appraisal Needs and Service plans, and signed Admission Agreements. There was no documentation showing TB results for Resident #1 (R1). Licensee states and the physician report shows a chest x-ray was completed, but the results are not listed. Deficiency cited. Planned activities are offered to residents in care. Staff records were checked for expired or missing certificates and clearances: LPA conducted a file review of 5 staff for criminal record clearances/associations, Health screening with TB results, current First Aid/CPR, and Administrator Certificate. The CPR/first-aid certificate for Staff #1 (S1) expired on 3/23/23. Technical violation given. LPA reviewed Staff Training Records. Training records were present with a minimum of 20 hours completed for the past year. Medications are in a centrally stored and locked cabinet in the garage, including over-the-counter medicines. Medications are properly labeled and checked for expiration dates. Each centrally stored prescription and PRN medication has been logged in the medications log with proper documentation from the residents’ doctor. Proper medication dispensing instructions are followed. The first aid kit has all proper items and is current. Exit interview conducted, deficiency cited and the report and appeal rights given.