Routine inspection·June 24, 2025

LPA Audrey Jeung toured facility and grounds. This one level facility consists of 5 client rooms--all of which have private half bathrooms and exits--a staff room with one bed, bath/shower room, living and dining rooms, kitchen, and attached 1 car garage. Two residents currently receive hospice services. There are no accessible bodies of water or fire safety hazards observed. Medications, toxins and sharps are stored appropriately and inaccessible to clients, a comfortable room temperature is maintained, and lighting is sufficient for safety. Carbon monoxide detector is tested and operable. First-aid kit is maintained and complete. Medications are stored in locked cabinet in dining room. Chemicals and cleaners are stored in garage and locked kitchen cabinet. The backyard is fenced and gated; all bedrooms access wood ramp. Client and staff records are reviewed. Criminal record clearances or exemptions for facility staff or other individuals who have client contact have been reviewed. Training records and medications may be reviewed at a later date. Ferlene Giusto is a certified RCFE administrator (x 7/25) that oversees facility operations. The following information is provided to LPA today: - updated Personnel Report (LIC500) Proof of current liability insurance to be sent to CCLD BY 7/8/25. Deficiencies of the California Code of REgulations, Title 22 are cited on a following pages. See page TWO for Hospice Care Plan requirements. HOSPICE CARE OF TERMINALLY ILL RESIDENTS A current and complete hospice care plan shall be maintained in the facility for each hospice resident and include the following: (1) The name, office address, business telephone number, and 24-hour emergency telephone number of the hospice agency and the resident's physician. (2) A description of the services to be provided in the facility by the hospice agency including but not limited to the type and frequency of services to be provided. (3) Designation of the resident's primary contact person at the hospice agency, and resident's primary and alternate care giver at the facility. (4) A description of the area of licensee’s responsibility for implementing the plan including, but not limited to, facility staff duties; record keeping; and communication with the hospice agency, resident’s physician, and the resident’s responsible person(s), if any. This description shall include the type and frequency of the tasks to be performed by the facility. (A) The plan shall specify all procedures to be implemented by the licensee regarding the storage and handling of medications or other substances, and the maintenance and use of medical supplies, equipment, or appliances. (B) The plan shall specify, by name or job function, the licensed health care professional on the hospice agency staff who will control and supervise the storage and administration of all controlled drugs (Schedule II - V) for the hospice client. Facility staff can assist hospice residents with self-medications without hospice personnel being present. (C) The plan shall neither require nor recommend that the licensee or any facility personnel other than a physician or appropriately skilled professional implement any health care procedure which may legally be provided only by a physician or appropriately skilled professional. (5) A description of all hospice services to be provided or arranged in the facility by persons other than the licensee, facility personnel, or the hospice agency including, but not limited to, clergy and the resident's family members and friends. (6) Identification of the training needed, which staff members need this training, and who will provide the training relating to the licensee’s responsibilities for implementation of the hospice care plan. (A) The training shall include but not be limited to typical needs of hospice patients, such as turning and incontinence care to prevent skin breakdown, hydration, and infection control. (B) The hospice agency will provide training specific to the current and ongoing needs of the individual resident receiving hospice care and that training must be completed before hospice care to the resident begins. (7) Any other information deemed necessary by the Department to ensure that the terminally ill resident’s needs for health care, personal care, and supervision are met.