Routine inspection·April 24, 2023

LPA Grace Donato & LPM Jackie Jin conducted an unannounced annual visit to the facility. LPA & LPM met with the administrator Deborah Dahlen. LPA & LPM toured the facility inside and outside with the administrator. While touring the facility it was observed that the temperature was af 78 deg F. Hot water was also tested and temperature was 110 deg F.Each resident rooms were checked. The residents have adequate amount of linens and incontinence care items. All personal belongings are intact. All residents are comfortable and taken care of. Carbon monoxide monitor is working properly. All fire extinguishers have been checked. Bathrooms were observed to be in good repair equipped with non-skid mats and grab bars. There is also adequate amount of food. 2 days for perishables and & 7 days non-perishable. Medication review was done and all medications are accounted for and centrally stored medication records are updated. One staff record was reviewed. All staff has criminal record clearance and are associated with the facility. Based on record reviews, it was noted that the facility does not have updated CPR & First Aid training. Personnel records are not maintained resulting for some documents being unavailable when needed. Resident records are checked and all are complete and updated. One out of one resident is in hospice and it was observed that the Hospice agreement was not in the file. Outside the facility, there were several sharps found around the garden area, the administrator corrected the deficiency by storing them on a locked shed. While touring around the facility, it was observed in the bathroom that chemicals were unlocked cabinet. Administrator cleared the deficiency by installing a lock for the cabinet. It was also observed that there were several chemicals in the garage. Deficiency was cleared by fixing the lock for the garage door so it won't be accessible to the residents. Facility doesn't have a record of Emergency Disaster drill log. LPA & LPM advised administrator that drill shall be completed quarterly. LPA requested licensee to submit the following by 4/28/2023: LIC 308 Designation of Facility Responsibility LIC 610D Emergency Disaster Plan LIC 500 Personnel Report Updated Administrator Certificate Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC809-D. Failure to correct the deficiencies may result in civil penalties. Report is reviewed with Co-Administrator and a copy is provided with appeal rights.