Routine inspection·May 14, 2024

On 5/14/2024 at 8:53 a.m. Licensing Program Analyst (LPA) Maria (Mita) Partoza arrived at the facility and conducted an unannounced required 1 year annual inspection and met with the administrator (ADM) Bernelette Taa. LPA stated the purpose of the visit. The facility is a Residential Care Facility for the Elderly (RCFE) catering residents from ages 60 and above, who are ambulatory, with physical and mental functional limitations. The facility current residents is 5 (R1 to R5) and 1 staff at the time of the visit. 2 out of 5 resident is not in the facility. ADM stated R1 has a scheduled medical appointment and R2 is out walking. 2 staff (S2 and S3) are not in the facility. 1 out of 2 staff is on-call basis or as needed. 1 out of 2 staff is currently on a leave of absence with no projected time of return as stated by the ADM. At 9:20 a.m. LPA with ADM toured the facility inside and outside, including but not limited to the kitchen, dining room, bathroom, living room, resident's rooms, office area, backyard and garage. LPA observed that the residents just finished their breakfast. LPA observed 2 days of perishable food and the refrigerator temperature is at 38 degree F and freezer at 0 degree F. LPA observed that the kitchen, dining room, and living area are accessible and are free of debris at the time of the inspection. LPA observed, that the laundry area is in the garage. The garage stores the cleaning supplies, laundry detergents, knives and other chemicals. The garage has a separate storage for 7 days of non-perishable food. The door to access the garage has a code keypad lock and remained locked during the time of inspection. page 1 LPA observed that 1 bathroom is shared by 5 residents. 1 bathroom is used by staff. The bathroom has skid mats and grab bars, the water temperature ranges from 105 degree f to 113.7 degree F. LPA observed the toilet seat has a safety rail/grab bar attached. The back area of the toilet seat rail/grab bar has corrosion and rust. LPA observed that exit doors are easily accessible and free from obstructions. The backyard has a pool with no water, fenced in and not accessible. At the side of the building is a fifth wheel trailer and not accessible. The facility temperature is at 69.7 degree F. Smoke and carbon monoxide alarms are in good working condition. The fire extinguisher was replaced on 4/5/2024. LPA observed that medications are locked and are not accessible to residents. The fire drill and disaster training was last conducted on 5/3/2024. LPA observed 3 out of 5 (R3 to R5) were at the facility, 1 out of 3 was watching TV, 1 out of 3 was on the exercise bike. LPA observed an individual in the staff room. ADM stated that the individual is a relative and is fingerprint and background cleared. LPA checked guardian and the individual is cleared on 4/30/2024. LPA reviewed 3 resident file and 1 staff record. During the document review, LPA observed that 2 out of 5 resident was under the age of 60 (R3 and R4). Deficiencies were cited during today's visit per California Code of Regulations (CCR) Title 22. See LIC 809D. An exit interview was conducted during today's visit. A copy of the report and appeals rights were provided. end of report page 2