Routine inspection·October 16, 2024

Licensing Program Analyst (LPA) Marcela Yanez and Christine Dolores conducted an unannounced Required 1 Year visit and met with Aaron Dell Coronel Administrator. During visit, LPAs toured the facility inside and out with staff. 4 resident's observed in the living room area. 5 staff observed present are fingerprint cleared and associated to facility. LPAS toured the outside area and found the exits to be clear of obstructions. LPAs entered the garage area and observed cabinets of non-perishable foods and locked cabinets for cleaning supplies. LPAs observed the garage has a built-in storage room located to the back left of the garage, which the Licensee states was installed about 2 months ago. Licensee states the fire Department visited the facility and stated a permit is not needed as the purpose of the room is for storage. Facility temperature maintained at 74 degrees F. LPA observed the kitchen area and observed locked cabinets for medications and sharp objects. LPA observed perishable food supply of at least two days and a non-perishable food supply of at least seven days. Refrigerator temperature maintained at 37 degrees F and freezer temperature maintained at -3 degrees F. LPA entered 3 resident bedrooms. Each bedroom had available bedding and clothing storage areas as well as functioning lights. 2 resident beds observed with full bed rails. LPA toured one resident bathroom. Resident bathroom had available soap, paper towels and functioning lights. Shower equipped with grab bars and non-slid mats. The water temperatures in the bathroom sink measured using a thermometer at 158.0 degrees F. Licensee adjusted the water heater during visit and LPAs measured the hot water temperature using a thermometer to be at 112.1 degrees F. LPAs observed first aid kit was complete. Facility has flashlights and batteries. LPA observed the fire extinguisher was last serviced on 10/26/2024. Carbon monoxide detector present. LPA reviewed Fire and Earthquake drills was last conducted on 07/2024. Page 1 of 2. Page 2 of 2 3 resident records were reviewed and observed complete to include the admission agreement, physician's report, TB result, updated needs and services plan and/or IPP, identification and emergency contact information, safeguard of personal properties and valuables, personal rights, and consent forms. 3 residents centrally stored medications and P&I money observed maintained. Based on record review, 2 resident's who are using full length bed rails does not contain a physician's order for full length bed rails. LPAs observed the physician's orders states the use for side rails, but the order did not indicate if the side rails were for half or full. LPAs reviewed the facility file and the facility did not submit an exception request for the use of full length bed rails. Based on record review, 2 resident's appraisal/needs and services plan and IPP did not include the need for full length bed rails. LPA reviewed 3 staff records and found them to be complete to include a health screening, TB result, job application, fingerprint clearance and 1st aid certification. 3 staff files contains at least 20 hours of annual training. Documents were requested to LPA Dolores by 10/17/2024: - LIC500 (Personnel Report) - Liability Insurance - Lease Agreement Deficiencies were cited as per California Code of Regulations Title 22. This report was reviewed with Administrator, Aaron-Dell Coronell and a copy of this report and appeal rights were provided.