Routine inspection·November 25, 2024

Licensing Program Analyst (LPA) Christine Dolores arrived unannounced to conduct the facility's required 1 year annual inspection. LPA met with Administrator, Judy Reyes. During visit, LPA toured the facility with the Administrator to include the kitchen, dining room, resident bedrooms, bathrooms, laundry room, garage, and exterior. All fire exit routes are free and clear of obstruction. There are 3 staff to 3 residents present. All staff are fingerprint cleared. Facility temperature maintained at 68 degrees F. Kitchen is supplied with at least 2 days worth of perishables and 7 days worth of non-perishable foods. Refrigerator temperature maintained at 36 degrees F and freezer temperature at 0 degrees F. Resident bedrooms equipped with individual beds, linens, night stand, closet space, and adequate lighting. Each resident bedroom has overhead lifts. Resident (R1)'s bed is equipped with half bed rails. Facility was unable to produce the physician's report for the use of half-bed rails for resident (R1). Administrator states R1 uses the half bed rails for mobility. Bathroom is equipped with hygiene and paper supplies. LPA Dolores did not have a water thermometer during visit. The Administrator measured the hot water temperature in the bathroom using the facility's water thermometer, LPA observed the hot water is maintained at 108 degrees F. Facility has an infection control plan. LPA observed PPE supplies to include face shields, gloves, and gowns. Facility has an emergency disaster plan. Emergency drills are being conducted quarterly. Facility's fire inspection was completed on 04/10/2024. See LIC809-C. Fire extinguisher last serviced on 08/12/2024. LPA observed an operable carbon monoxide detector located in the hallway. Emergency bins filled with medical supplies and non-perishable foods observed in the garage. Each resident has a grab and go backpack. LPA observed lanterns (emergency lighting) throughout the facility. LPA reviewed 2 resident's files are maintained and complete. 2 residents centrally stored medications and centrally stored medication records observed maintained. 2 resident's P&I money was reviewed with the Administrator and all money was accounted for. LPA reviewed 2 staff files are complete to include a fingerprint clearance, 1st aid certification, health screening, TB result, and job application. The Administrator was unable to produce at least 20 hours of annual training documentation for the 2 staff. The Administrator states plan to ensure all staff completes the required 20 hours of annual training. Documents were obtained to include the updated liability insurance and LIC500. Deficiencies were cited per California Code of Regulations, Title 22. See LIC809-D. This report was reviewed with Administrator, Judy Reyes and a copy of the report and appeal rights were provided.