Routine inspection·December 21, 2024

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced annual inspection visit, and met with Staff (S1), Concordia Casabar. During the visit, LPA observed 5 residents and 2 staff. LPA explained the purpose of the visit. Staff S1 contacted ADM and informed her about LPA's visit. ADM stated she could not come to the facility and Staff S1 could sign on her behalf. LPA toured the facility inside out with S1 which included the Living room, kitchen, dining room, 3 restrooms and 5 residents bedrooms. The staff area of the facility was also inspected. The front yard and backyard were inspected. While touring bedroom #3, LPA observed wheel chairs obstructing Exit#2. LPA also observed a stick, in the pathway of the sliding screen door, preventing the sliding screen door from opening. (Photographs were taken.) ADM stated the staff may have put the stick there for safety and forgot to remove it. Staff S1 removed the obstructions during LPA's visit. While touring the backyard, LPA observed the fence near exit #2 was partially leaning. LPA also observed the fence next to exit #2 had a section, leading to the front of the home, that had sections of the fence that had wooden planks missing. (Photographs were taken.) LPA also observed the hand rails of the wooden deck had sections that were splintering and had sections that had moss growing. (Photographs were taken.) LPA also observed the metal white sections of the wooden deck was rusting. LPA also observed the wall next to the hose, directly next to exit number 4 has an orange color on the wall. (Photographs were taken.) While touring bathroom #3, LPA observed the shower's wall mount soap dish fixture had tape covering, which was being used to cover the damaged. (Photograph was taken.) Page 1 Out of 2. Two-day perishable food supplies and seven day nonperishable food supplies were observed. LPA observed the medication storage area, knives storage area, and cleaning product storage area as locked and inaccessible to residents in care. Room temperature was at 70 degrees F, and hot water temperature was measured at 116 degrees F. Fire extinguisher was serviced in January 5, 2024. The facility was equipped with smoke and carbon monoxide detectors. Smoke detectors was tested by S1, and were functional. LPA observed facility first aid kit. The facility's last fire/earthquake drill conducted was on May 14, 2024. LPA reviewed facility records for 3 staff and 3 residents. LPA requested to review R1 and R2's needs and services Plans. ADM stated if the forms are not in the file, then she didn't do them. LPA reviewed 3 resident medications and centrally stored medication records. LPA conducted interviews with 2 residents. LPA requested copies of the following updated documents; 1.LIC 500, Personnel Summary 2.LIC 308, Designation of Administrative Responsibility 3.LIC400, Affidavit Regarding Client/Resident Cash Resources 4. Liability Insurance 5. LIC200, please update (i.e., new phone numbers etc), if necessary. 6. Qualifications of Administrator (Certificate) 7. Please review your facility program for updates (incorporating new laws and/or regulations) LPA provided ADM with CDSS Flyer, "Important updates to Dementia Care and Miscellaneous Changes, effective January 1, 2025." Deficiencies are being cited during today's visit. This report was reviewed with Staff Concordia Casabar and a copy of the signed report was provided. Appeal rights were provided. Page 2 Out of 2. END OF REPORT.