Routine inspection·May 22, 2024

On 5/22/2024 at 1:00 p. m. Licensing Program Analyst (LPA) Maria (Mita) Partoza arrived and conducted an unannounced required 1 year inspection visit and was greeted by resident 1 (R1) and staff (S1). Administrator, Diana Natividad was not present upon LPA's arrival. Staff contacted administrator and arrived shortly thereafter. LPA stated the purpose of the visit with ADM. LPA observed COVID-19 signs posted on the door prior to entering. The facility is a Residential Care Facility for the Elderly (RCFE) licensed to serve ages 60 and over and 6 of the residents may be non-ambulatory. Currently the resident has 3 ambulatory and 2 non-ambulatory residents that have neurocognitive impairment. 1 staff were present at the time of the visit. 1 out of 5 residents is at the rehabilitation center. 3 out of 5 are present at the facility and 1 out of 5 is in the living room watching television. At 1:22 p.m. LPA toured the facility inside and outside with ADM, including but not limited to the kitchen, bathroom, dining room, living room, residents’ rooms, staff room, backyard and walkways. LPA observed the Personal Rights disclosure, Long Term Care Ombudsman (LTCO) and Centralized Complaint and Information Bureau (CCIB) of the CA Department of Social Services (CDSS) prominently posted on the wall, visible to visitors, resident, and staff. The temperature inside the home was at 68 to 69.8 degrees F. . page 1 - see LIC 809C for page 2 LPA and ADM toured 4 resident bedrooms and 1 staff room. LPA observed the rooms to have storage spaces that are sufficient to hold the resident’s personal belonging. 2 out of 4 residents’ room are shared room and 2 out of 4 are private room. 4 out of 4 bedrooms has exit doors leading to the backyard and are free from obstruction. LPA observed that 4 out of 4 resident bedroom floor requires maintenance from visible food particles. LPA observed a commode inside one of the shared bedrooms. LPA observed the smell of urine permeating inside the facility. LPA observed that 2 of the bathrooms has grab bars and anti-skid mats, trash bins with lids. LPA observed bathrooms require maintenance such as but not limited to the upkeep of the sink, toilet, bathroom floor, tub and shower areas. LPA observed residents’ bed linens require attention and maintenance. LPA observed that the facility has a wall pull fire alarm system but is not connected to the fire department emergency line. S1 stated the pull fire alarm is only for the facility to notify residents. S1 tested the wall pull alarm and it is in good working condition. The facility has carbon monoxide alert system that is in good working condition. LPA observed smoke alarms in the hallways and the resident bedrooms and are in good working condition. LPA observed night lights on the hallway. Hallways are free from obstruction. The doors going to the backyard from the living area open with ease and is not obstructed. LPA observed walkways and ramps are free from obstruction and in good condition. LPA observed a gazebo in the backyard utilized as storage for items that are no longer used such as but not limited to walkers, wheelchairs, barbeque pit, a metal drink cooler that requires maintenance, an oxygen concentrator machine and boxes piled and stacked up. The contents are not visible to LPA. LPA tested the water temperature for kitchen and bathrooms, water temperature was measured at 107 degrees F Dining, kitchen and living room area were observed to be sanitary and organized. The facility has sufficient supply of perishable food for 2 days and non-perishable food for 7 days. The fire extinguisher located in the kitchen is monitored by S1 and logs the date when checked. page 2 LPA and ADM inspected the laundry area. LPA observed the laundry area is located at the garage. The washer and dryer are in good working condition, the laundry area has a cabinet that stores laundry detergents and cleaning supplies are kept locked and not accessible to residents. LPA with ADM inspected the medication cabinet. LPA observed the medication cabinet is locked and is not easily accessible. LPA observed first aid kit in the kitchen cabinet. LPA observed that knives and sharp are locked and not accessible to residents. LPA reviewed facility record, 3 out of 3 staff record and ADM stated that the facility's fire drill training was last conducted on 12/1/2023 and next training will be conducted this month of May 2024. Staff training records were up to date. Staff records were reviewed with current first aid certifications, clearance and training. Residents' medications are labeled and current. LPA reviewed 3 out 3 resident records and observed that 2 out of 3 did not have an updated needs and services plan. Deficiencies are cited during today's visit based on the California Code of Regulations (CCR) Title 22, see LIC 809D. An exit interview was conducted with administrator Diana Natividad. A copy of the report and appeals rights were provided. end of report page 3