Routine inspection·April 22, 2025

Licensing Program Analysts (LPAs) Coppo and Contreras arrived unannounced to conduct a required Annual inspection and was greeted by Administrator Estrella Valendo. At approximately 10:30am LPA and Admin toured the building and grounds. The facility was found to be at a comfortable temperature. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable food. Frozen chilis found opened and uncovered in freezer expired from October 2024.Frozen mushrooms found with black and brown substance unwrapped. Head of lettuce found in overflow refrigerator with black and brown substance with pooling liquid in wrapping. Bread packages found expired from March 2025.Rice container found with live bugs crawling and noticeable rodent droppings inside rice container (deficiency cited, see 809D). Sharp knife found in kitchen drawer unlocked. Sharps container found in kitchen counter accessible to residents, LPAs discussed with admin maintaining location of sharps container inaccessible to residents( deficiency cited, see 809D). All bedrooms were equipped with lighting, night stand, and chest of drawer. Bedrooms have doors leading outside alarms present but not operational. LPAs discussed with admin ensuring doors have operating alarms. Room two (2) had noticeable odor of incontinence . Additionally, facility has a cat and incontinence odor could also be from animal waste( deficiency cited, see 809D). Resident bathroom had required bath mat and grab bar. Bathroom found without any paper towels to dry hands. Bathtub faucet in disrepair. Toxins found in laundry room was found unlocked. Dryer and washer found operational. Water temperature in sink accessible to residents in care measured at 105.1 degrees F which is within the allowable range of 105 to 120 degrees F. continued on 809C.... continued from 809.... Fire extinguishers were last inspected 2/26/2025. Smoke/Carbon Monoxide detectors located throughout the facility were not operational as the actual detector was removed and not connected to the wires in the ceiling. Administrator stated that detectors will be replaced by construction workers( deficiency cited, see 809D). Currently facility is under going construction in the backyard; they are building a studio apartment. Backyard is not accessible to residents as many trenches are open, exposing pipes and presenting tripping hazards. Additionally, pavers present but scattered and stacked among mounds of dirt. Administrator stated they do not have a building permit but are in the process of applying for one. LPA's discussed with admin that residents are required to have a safe area in and have access to an outdoor area with shade provided present for activities (deficiency cited, see 809D) Staff bedroom found in garage had vermin droppings and noticeable odor of decay (deficiency cited, see 809D) At approximately 12:15am LPA conducted a review of 3 resident records. All required documentation present. At approximately 12:30am LPA conducted review of 2 staff records. S1 is fingerprint cleared but is not associated to the facility. Per admin, S1 is a part time employee. LPA discussed with admin all employees much be associated to the facility whether or not part time. Training for S1 not present or on file. All other required documentation present. LPA's and admin discussed that part time employees must have training completed even if they are just part time (deficiency cited, see 809D). At approximately 1:00pm LPA and Admin conducted a spot check of medication and medication records. Medication is centrally stored in a locked cabinet. Food thickener found in unlocked cabinet with other perishables. Administrator put away thickener and moved to medication cabinet. Single pill found in pre-poured container on table counter. Another single pill found on kitchen counter accessible to residents. Continued on 809C(2).... continued from 809C.... Refrigerated prescription medications are locked but over the counter medication also stored in refrigerator. However, refrigerator does not have lock. LPAs discussed with admin to get a locking refrigerator or putting a lock on ( deficiency cited, see 809D) . Newly prescribed medication not on Centrally Stored Medication Log (CSML) for R1 . LPA's compared doctors orders to CSML and found some medications prescribed but not on CSML. Facility uses a MAR and medications missing from CSML were found on the MAR. However, LPA discussed with admin use of MAR good policy but all medications must be listed on CSML( deficiency cited, see 809D) . Estrella Valendo Administrator Certificate 7001499740 expires 10/17/23. However, LPA verified admin is currently on Pending List. LPA and Administrator discussed facility's Infection Control Plan and Emergency Disaster plan. No new updates. Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: LIC500- Personnel Report LIC308- Designation of Responsibility Liability Insurance Copy of Deed Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Appeal rights given and discussed with Administrator. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with administrator.