Routine inspection·February 14, 2024

On February 14, 2024, Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. LPA met with administrator and explained the purpose of today's visit. LPA toured the facility with administrator. The facility is a two story building. No accessible bodies of water or fire safety hazards observed. The indoor and outdoor passageways were free of obstruction. LPA randomly toured 10 resident rooms at the facility. All bedrooms observed with emergency call buttons, adequate furniture, and sufficient lighting. Bathrooms/shower rooms and toilets have grab bars and non-skid mats. Hot water temperature in the kitchen, 2nd floor living/activity room, shower/bathrooms and resident rooms were measured at 105-113 degrees F. LPA toured the kitchen and observed 2-days perishable and 7- days non-perishable present. Linen closet was reviewed. Bed sheets, linens, and towels were observed to be sufficient. Medications are locked in the medication room on the 1st floor and inaccessible to residents in care. Chemicals, toxins, and sharps objects were locked and inaccessible to residents. Facility is equipped with smoke detectors and carbon monoxide detectors. Fire extinguisher was last serviced on 2/2/2024. Fire drill records observed to be sufficient. LPA reviewed 5 resident records that contained Admission Agreement, Appraisal Needs and Service Plan, Resident Identification information, Pre-appraisal assessment, and 1 out of 5 resident's medical assessment (LIC 602) was not updated. LPA reviewed 4 staff files and all of them contained personnel records, health screening, Abuse Statement, First Aide/CPR, Criminal Record Statement, fingerprint cleared, and training records. Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. This report is reviewed and discussed with administrator. A copy of this report and the appeal rights were provided.