Routine inspection·October 10, 2024

Licensing Program Analysts (LPAs) Marcella Tarin and Manuel Monter conducted an unannounced annual inspection visit, and met with Administrator (ADM) Geralyn De Ocampo . LPAs toured the interior and exterior of the facility with ADM to include the dining room, kitchen, resident bedrooms, hallway bathrooms, and patio areas. LPAs toured the kitchen area and observed a perishable food supply of at least two days and a non-perishable food supply of at least seven days. The refrigerator maintained at 37.8 degrees F and the freezer maintained at below 0 degrees F. The facility temperature is maintained at 72 degrees F. LPAs toured the facility inside and out, including 9 resident bedrooms. 9 out of 9 resident bedrooms inspected had functioning lights, a bed, cleaning bedding, a chair, a dresser and storage for resident personal belongings. While touring resident bedroom #111, LPAs attempted to open sliding glass door and observed a plastic tube obstructing the sliding door, preventing the door from opening (photos taken). ADM removed plastic tube obstructing sliding door during visit. LPA asked ADM why the plastic tube was obstructing the sliding door. ADM stated the tube was placed to prevent caregivers from going in and out through the door. LPA advised ADM that all resident passageways must be free of obstruction. While touring Memory Care, LPAs tested delayed egress door #4 (next to resident rooms #124 and #125). LPAs pushed the door completely open, and the delayed egress did not sound the alarm. LPAs informed ADM that the door did not sound. A caregiver activated egress door with a key, and the delayed egress was activated. LPAs tested the door again and it activated the alarm. LPAs asked ADM why the delayed egress alarm was not activated. ADM stated she did not know why it was not activated, and that it's policy for the alarm to be on at all times. SEE LIC809-C LPAs measured the water temperature between 116 to 118 degrees F in two restrooms on the first floor of the facility. The facility was equipped with smoke and carbon monoxide detectors. Fire extinguishers were last serviced on 02/01/2024. LPAs observed the facility first aid kit and it was observed to be complete. The facility fire/earthquake drill log was reviewed. The facility's last emergency drill was on 09/21/2024. LPAs reviewed facility records for 4 staff and 4 residents. LPAs observed 4 out of 4 staff records as complete to include fingerprint clearance, health screening. LPAs observed 4 out of 4 resident records as complete to include a medical assessment, TB result, updated appraisal/needs and services plan, identification and emergency contact information, personal rights, and consent forms. LPAs reviewed 4 residents Centrally Stored Medication and Destruction Records (CSMDR). LPAs observed 4 out of 4 CSMDRs are complete with all medications accounted and documented. LPAs observed the medication storage area was locked and inaccessible to residents in care. LPAs interviewed 4 residents and 1 staff member. Deficiencies were cited during today's visit as per California Code of Regulations Title 22. See LIC809-D for more information. This report was reviewed with ADM Geralyn De Ocampo and a copy of the signed report and appeal rights were provided