Routine inspection·June 22, 2023

On 6/23/2023, Licensing Program Analyst (LPA) Tobola conducted an unannounced Annual Required – 1 yr. Inspection for this facility and was greeted by Licensee, Debra Ann Best. The facility currently provides care for one resident, who was not present at the time of visit and attending day program. Resident is diagnosed with dementia but not receiving hospice services. LPA informed that the resident is picked up directly from the facility throughout the week to attend program. LPA arrived at the facility and had temperature checked and logged. LPA continued with a tour of the facility with Licensee; facility was found to be clean and at a comfortable temperature. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguisher was found to be last charged on 10/10/2022. Smoke and carbon monoxide detectors were tested throughout the facility and found to be in working order. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Food stored in the kitchen refrigerator were stored properly as per regulations on this day at the time of the visit. There was a supply of linens, hygiene products and paper products available for residents located in the hallway. All resident’s bedrooms have lighting & appropriate furnishings with bedrooms well maintained and cleaned by staff. LPA toured the backyard and observed a storage shed that was found to be secure and emergency exit was unobstructed. Water was tested at faucets accessible to residents and measured between 105.0 and 105.2 degrees F which falls within Title 22 regulation. Sharps, cleaning supplies and other items that could pose harm if accessible to resident in care were found to be locked and secured in the garage and under kitchen and bathroom sinks. Medications are located in a designated cabinet located in the kitchen with administering and prescription records in order. Continued onto LIC809C LPA conducted a sample file review for staff and found staff to have 1st Aid & CPR training up to date. Upon review of staff training, LPA found that all staff are in need of annual training. LPA provided assistance and requested for Licensee to develop plan on organizing and implementing in-service and online training options. Technical Violation issued. LPA also conducted a file review for all residents and found medical documentation up to date. However, LPA found that resident (R1) requires an updated Needs & Service Plan. License agrees to update documents submit to CCLD. Technical Violation issued. LPA and Licensee reviewed the current Guardian staff roster and found that two staff (S1 & S2) that have been associated to the facility previously are currently off the roster. Licensee has submitted forms to CCLD for association for R1 but was not fully processed. LPA also found that both S1 & S2 have eligible clearance, however Licensee is to submit updated forms to CCLD. LPA to provide support and confirm proper association. Technical Advisory issued. Licensee, Debra Ann Best's Administrator Certification 6023425735 is valid through 1/10/2023. LPA requested the following documents be sent to CCL by COB 7/23/2022: LIC 308 Designated Facility Responsibility LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan LIC 9020 Register of Facility Client’s/Resident’s Liability Insurance No deficiencies cited during today's visit. No deficiencies cited during today's visit. Appeal Rights Given.