Complaint·July 23, 2024

LPA with DADM toured the interior of the facility, including but not limited to the kitchen, dining, and 5 resident's bedroom (R1 to R5). LPA observed there are 6 rooms in the facility and one is vacant and is being renovated. LPA observed that 4 out of 5 residents were non-ambulatory and 1 out of 5 is ambulatory. R1 to R5's bedroom were kept sanitary and free from obstruction and debris. Sliding door of each room are free from obstruction and easily opened. LPA observed the strip of door seal on R1s entry door frame was peeling off. ADM stated the door strip will be replaced. LPA with ADM toured the front yard and observed no obstructions on walkways. The front yard and backyard grounds are constructed to drain the water away from the building structure. Based on LPAs observation and interviews the preponderance of evidence standard has been met, therefore the above allegation(s) were found to be substantiated based on California Code of Regulation (CCR) Title 22, Division 6, Chapter 8, 87303 for Maintenance and Operation*. LPA discussed the deficiencies with the LIC/ADM. Correction were made at the time of the visit on 7/23/2024. Deficiencies were cited during today's visit. See LIC 9099D. An exit interview was conducted with administrator (ADM) John Gryspos and designated administrator (DADM) Adrian Mendoza. A copy of the report and appeals rights were provided. *87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. (1) Floor surfaces in bath, laundry and kitchen areas shall be maintained in a clean, sanitary, and odorless conditio n (e) Water supplies and plumbing fixtures shall be maintained as follows: (5) Non-skid mats or strips shall be used in all bathtubs and showers. page 2 of 2 end of report Based on interview with responsible parties (RP1 to RP4) for residents R1 to R5, the following statement are as follows: RP1 stated to help R1 have familiarity with the new living space, the family have brought in personal items such as but not limited to bed sheets, pillows and pillow cases. RP1 stated the items are not new. RP1 stated that the facility will do laundry once a week or as often as necessary. RP1 stated the stains in the pillow cases were there prior to R1 moving in to the facility. RP2, stated he/she is the responsible for two of the residents R2 and R3 who were admitted in 2020 and 2022. RP2 stated, he/she visit regularly, unannounced and observed the facility changes and washes linens and clothing on a regular basis and did not smell any foul odor when visiting. RP3 stated, he/she is the responsible party for R4, and visits R4 on a regular basis, unannounced, and have no problem with the facility. RP3 stated he/she observed that bed linens are washed and changed regularly and as needed and did not smell any foul odor in R4s room. RP4 stated, R5 was admitted at the facility in 2018. RP4 stated he/she visits R5 on a regular basis, unannounced and observed R5 bed linens are washed and changed on a regular basis and did not smell any foul odor in R5s room when visiting. This agency has investigated the complaint alleging staff do not ensure the linens are clean. We have found the complaint was unfounded, meaning the allegation was false, could not have happened and/or is without a reasonable basis. No deficiencies were cited. An exit interview was conducted with Administrator John Gryspos. A copy of the report was provided. End of Report. page 2 of 2