Routine inspection·April 7, 2023

Licensing Program Analysts (LPAs) Chavez and De Leon arrived at the facility at 9:22 am and made an unannounced 1-year required annual visit to the facility above. LPAs met with Meynard Marcos, Licensee/Administrator, and explained the purpose of the visit. LPAs requested a staff roster, a resident roster, emergency disaster plan, documentation of quarterly emergency drills. LPAs provided administrator the entrance checklist and asked for a physical plant tour. A tour of the physical plant was assessed, and the following was noted: LPAs observed the license posted, personal rights, LTCO poster, CCL Complaint poster and COVID signs. The facility has 6 bedrooms with 3 bathrooms, kitchen, living room, dining room, garage, and medications locked in a cabinet in the kitchen, covered patio with chairs for resident use outside. Physical plant was checked for cleanliness and condition. Walls and baseboards had markings, the wall in the dining room has a puncture with broken stucco and paint coming off, windows and sliding glass doors have dirt/dust, the ceiling in the entrance way has pieces breaking off and per the licensee, it was leaking water during recent storms, walls in dining area have unfinished painting, and dust on appliances. The sliding door in the dining room was missing an exiting door alarm. The garage storage room has a bent window screen with small holes/breaks in it. The facility needs to fix outside gates to be self-closing and self-latching. The kitchen vent and cabinets above have grease and need cleaning, the microwave has food splattered on the walls, and the kitchen floor is sticky. The facility maintains a comfortable temperature. The facility provides working telephones and on-line communication for resident use. The smoke detectors are hard wired, tested and working properly. The carbon monoxide detector was tested and operational. A fire extinguisher was last inspected 6/5/22 and shows charged in the green. There are no issues with Fire Clearance. Living and dining rooms furniture were functional and in fair condition. Continued on 809-C. LPAs reviewed 5 staff files with required forms were present: Personnel Record, 1st Aid & CPR, Fingerprint clearance and associations, Criminal Records Clearance, however, four staff were missing the Health screenings with TB results. LPAs reviewed Staff Training Records. Training records were present with a total of 17 hours completed and missing 3 hours annually. Additionally, required training included only one 1 hour of medications and 3 hours of hospice and did not meet the minimum 20 hours of annual training. LPAs reviewed 2 residents’ medications, medication reviewed were current on the CSMDR and MAR for 2 residents in care. No issues with medications and records. There are no bodies of water on the premises. There is plenty of lighting available for the safety of the residents. The kitchen area was sufficiently stocked with two-day perishable and seven-day non-perishables. Snacks and beverages are available for residents in the facility when they want. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. Garbage cans have tight fitting covers. Sharps and knives are locked in a drawer in the kitchen. The 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 needed. The bathrooms were checked for cleanliness and proper operation. The hot water temperature measured at 110.6 F in bathroom #1, bathroom #2 at 110 F, and bathroom #3 at 109.4 F. Towels and washcloths are not shared. Residents have a sufficient amount of supplies for personal hygiene. Soap and toilet paper are provided by the Licensee. Grab bars are secured in toilet and shower areas. Showers have non-slip mats. Resident records were reviewed for requirements and legibility: LPA reviewed 6 residents’ files for current Medical Assessments with TB results, Current Appraisal Needs and Service plans which were updated, signed Admission Agreements, consent forms, and immunization records. Pre-appraisals were missing from resident files. Planned activities are offered to residents in care. Infection control was evaluated, and the facility is in compliance. Exit interview conducted, Deficiencies cited, Technical Violations issued, and the report and appeal rights given to the licensee.