Routine inspection·September 22, 2023

Licensing Program Analyst (LPA) Christine Dolores arrived unannounced to conduct the facility's Required - 1 Year inspection. LPA met with Administrator (ADM), Lori Corral. During visit, LPA toured the facility with ADM to include the entrance, hallways, resident bedrooms, bathrooms, storage, shower rooms, kitchen, and exterior. All fire exit routes were free and clear of obstruction. Facility temperature maintained between 72 and 74 degrees Fahrenheit. Fire extinguisher last serviced on 08/31/2023. Carbon monoxide detector present in the facility. The main entrance is equipped with hand sanitizer, masks, and a lidded trash bin. Posters observed to include infectious disease prevention signs, visitation guidelines, facility license, personal rights, rights of resident council, evacuation plan, emergency phone numbers, if you see something say something, and ombudsman information. 13 out of 13 resident bedrooms contained beds, clean linens, adequate lighting, dresser, night stand, and chair. Shower room water temperature maintained at 122 degrees Fahrenheit. Suite #7 bathroom water temperature maintained at 116 degrees Fahrenheit. Kitchen observed with at least 2 days worth of perishables and at least 7 days worth of nonperishable foods. 2 out of 2 refrigerators temperature maintained at 39 degrees Fahrenheit. Freezer #1 temperature maintained at 0 degrees Fahrenheit. Freezer #2 temperature maintained at 15 degrees Fahrenheit. During visit, the facility's maintenance personnel began to repair the freezer. All foods were checked and re-located. LPA observed the activities calendar and menu was posted near the activity room and dining room. During visit, residents observed watching a movie in the dining room and participating in exercises in the activity room. SEE LIC809-C. Facility has an updated emergency disaster plan. LPA observed the facility has multiple flashlights and batteries. First aid kit complete with bandages, tweezers, gauze, scissors, thermometer, and manual. Last fire drill was conducted on 09/2022. The facility has not completed quarterly fire drills with all staff per shift. Administrator was advised. Facility has an updated infection control plan. LPA observed the facility has sufficient Personal Protective Equipment (PPE) supplies and a PPE storage bin which is readily available. 5 residents files were reviewed. 5 out of 5 residents included a signed admission agreement, medical assessment, TB, emergency information, appraisal/needs and services plan, personal rights, consent forms, safeguard of personal property and valuables, and centrally stored medication records. 5 staff files were reviewed. The facility has more than one person who obtains a 1st Aid certification. 3 out of 5 staff members did not have a health screening form on file. Administrator was advised. 5 out of 5 staff are fingerprint cleared and associated to the facility. 5 out of 5 staff were provided training on topics to include (but not limited to) resident personal care, special needs of the elderly, physical limitation, resident rights, medication, dementia care, emergency preparedness, housekeeping and sanitization protocols, postural support and special care, mandatory elder and dependent abuse, and incident reporting. 3 residents and 3 staff members were interviewed. Documents were obtained during visit to include liability insurance and Administrator Certificate. An updated LIC500 was requested by the Administrator by Monday, 09/25/23. Deficiencies were cited per California Code of Regulations, Title 22. This report was reviewed with Administrator, Lori Corral and Medication Technician Odalys Rodriguez and a copy of the report and appeal rights was provided.