Routine inspection·September 12, 2024

Licensing Program Analyst (LPA) M. Cuadra conducted an unannounced Annual Required 1 Year inspection and met with Administrator Helen Rabago. There are residents receiving hospice services and diagnosis of dementia. Annual fees are current. Required postings were observed. LPA/Administrator toured the facility inside and outside at approximate 10:00am and observed the following: Facility is clean, in good repair and at a comfortable temperature with all exits free from obstruction. Fire extinguisher charged and serviced February 2024. Smoke detectors and carbon monoxide detector were found to be all operational during the visit. Bathrooms were equipped with necessary grab bars and non-slip floors/mats. All three bedrooms used by residents did not have chairs as indicated per regulation . Administrator placed chairs on resident's rooms as stated per regulation (technical violation issued). Hot water temperature measured between 114.12 and 113.0 degrees F, in resident's bathrooms, which is within regulation of 105 to 120 degrees F. Last disaster drill was conducted on June 14, 2024. There is a minimum of one week supply of nonperishable foods and two days of perishable foods and it was stored and handled per regulation. However, during today's visit LPA did not observe any snacks been provided to residents in care. Per Administrator, sometimes they don't provide residents with morning snacks just afternoon. LPA discussed with Administrator that between meal nourishment or snacks shall be made available for all residents unless limited by dietary restrictions prescribed by a physician. Also, LPA did not observed any activities been encouraged to residents. Per Administrator, sometimes they go outside to exercise. There was an ample supply of hygiene products and paper products available for residents. Medication centrally stored and locked. Auditory alarms were present and operational. Continues on LIC809C... Continued from LIC809... During tour of the facility LPA/Administrator at approximate 10:30am observed a container of sharps including needles was sitting on top of the fireplace accessible to residents in care. Administrator removed the container immediately and placed it in the garage. At approximate 10:45am LPA initiated file review. Five resident's and three staff files were reviewed. Two out of five residents who has a diagnosis of dementia do not have a current medical assessment. Four out of five resident's (R1, R2, R3 & R4) care plans needs were updated, but not signed by their responsible party. LPA/Administrator discussed the importance of having resident's responsible party to acknowledge any changes of care plans. Resident (R5) sharing room with a person who is terminally ill does not have a current agreement to grant access to the shared living space to others on file (technical violation issued). Staff have required CPR/1st aid certificates and additional training hours. Administrator Certificate of Helen Rabago #6021326740 expires 10/28/2024. Medication and medication records were reviewed. Contact information was reviewed. Administrator agreed to submit copies of the following by not later than 9/20/24: LIC 308 Designation of Administrative Responsibility, LIC 500 Personnel Summary, LIC 610E Emergency Disaster Plan (if there are any changes), Copy of Liability Insurance Certificate and control of property. Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Administrator and a copy of this report was given.