Routine inspection·July 17, 2024

Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced required annual inspection to the above-named facility. Upon arrival, LPA was greeted by Staff 1 (S1). Administrator John Urquiola arrived at approximately 11:12 AM. At the time of arrival, there were 4 residents in care and 1 staff on duty. LPA explained the purpose of the visit. The facility is a Residential Care Facility for the Elderly (RCFE) and is home to non-ambulatory residents with a dementia diagnosis. There are no residents currently on hospice. Entrance interview conducted: A tour of the physical environment and accommodations were assessed, and the following was noted: LPA observed the required posting of the complaint poster, Resident’s Personal Rights, and Long Term Care Ombudsman poster. LPA inspected the one-story facility for fire safety, personal accommodations, and food service. First aid kit was observed to be complete. The physical environment was checked for cleanliness and condition. Walls, windows, ceilings, doors, floors and floor coverings were checked. The facility was seen to be in good repair inside and outside. Fire inspection was most recently conducted on 6/10/2024. There are eleven (11) dual carbon monoxide detectors/smoke alarms throughout the facility all in good working order. The kitchen area was sufficiently stocked with two-day perishables and seven days of non-perishables. Snacks and beverages are readily available for Residents. LPA observed the kitchen cabinets, refrigerator, stove, and counters are clean. Medications are stored in a cabinet located in the dining area. At approximately 11:03 AM, LPA observed the medication cabinet was not locked. S1 locked the cabinet immediately upon LPA’s request. At approximately 12:15 pm, medication inventory conducted revealed the following: Resident 1’s (R1’s) prescribed Levothyroxine 75MCG count had two (2) extra tablets, Losartan 100MG had one (1) extra tablet; Resident 2’s (R2’s) prescribed Escitalopram 10MG had one (1) extra tablet and Losartan Potassium 100MG was short one (1) tablet. Please continue to 809-C, Pg 2. Residents participate independently in games, music entertainment, neighborhood walks, and one-on-one socialization among the residents and staff. The front yard is well maintained and consists of walkways and garden areas. The backyard is well maintained and has a paved covered patio, sitting areas, and garden areas with a paved walkway surrounding the parameter of the yard. The backyard is conducive for outdoor visitation. The recycling bin, green waste bin, and trash bins are standard bins with flip lids. Chemicals and cleaning supplies are kept in a locked closet in the hallway. The kitchen, living room, and dining area are neat and clean. The facility maintains a comfortable temperature. Hallways, bedroom doors, and walls are in good repair. There are four private bedrooms available for four residents. There is a live-in staff room off the hallway that remains locked throughout the day and night. There are two bathrooms each with a shower room located in the hallway with access available to all residents. The bathrooms have secure grab bars and no skid flooring. Resident’s records are current. Personnel records and training records are current. All persons associated with the facility have a criminal record clearance and have been properly associated to the facility. The following deficiencies were observed (See LIC 809-D) and cited from the California Code of Regulations, Title 22. Failure to correct the deficiencies may result in additional civil penalties. Exit interview conducted. A copy of the report and appeal rights issued at the time of the visit.