Routine inspection·August 25, 2023

On August 25, 2023 Licensing Program Analyst(LPA) Murial Han conducted an unannounced annual inspection. LPA was greeted by caregiver, Glenda Tala and LPA explained the purpose of the visit. Caregiver assisted with the initial inspection and when the administrator and house manager arrived at the facility, they took over the rest of the inspection. LPA toured the facility inside and outside including the bedrooms (4 private rooms), 2 full- bathrooms, kitchen, living and dining rooms. The facility observed to be cleaned, tidy and in good repair. Bedrooms were equipped with the required furniture for residents to use. Bathrooms are equipped with grab bars, and nonskid mats. Facility temperature is comfortable. Hot water temperature was measured at 108-110 degrees F. Central stored medication, toxins and sharps objects were observed to be locked and inaccessible to residents. Emergency drills, central stored medication, and staff training records were reviewed. Food supplies were observed to be adequate. Facility is equipped with smoke detectors and carbon monoxide detectors. Fire extinguisher was last serviced May 17, 2022. Staff records were reviewed and contained criminal clearance, first aid / CPR certificate, Job Description, Abuse Statement, Health Screening with TB test result and criminal record statement. LPA reviewed resident's files contained resident's identification and emergency information, admission agreement, medical assessment, LIC 602 (Physician Order), Appraisal Needs and Service Plan, GGRC/IPP, etc. LPA reviewed P & I records for 3 residents, reconciled cash on hand with attached receipts. During today's inspection, there is 1 resident present and 2 were attending the adult day program. No deficiency cited today. This report is reviewed and discussed with the administrator. A copy is provided.