Routine inspection·July 21, 2023

Licensing Program Analyst (LPA), Araceli Canela arrived at Clarin's Residential Care Home for the purpose of conducting a Required-1 year inspection. LPA met with licensee/Administrator, Juliana Clarin and toured the inside and outside of the home. This facility is licensed for 6 non-ambulatory residents, with approval for 3 of the residents to receive Hospice services and there is no approval for bed ridden. LPA toured the home and found the home to be at a comfortable temperature with all exits free from obstruction. This home is a two storyClarin's Residentoa; home and the second level of the home is used by staff and there is a gate at the bottom of the stairs to make the second level inaccessible to residents. There are a total of 3 bedrooms in the first level of the home that are used by residents. LPA went over requirements for facility to have an auditory device for residents to use to call for assistance. The device must me working at all times for resident to be able to communicate or facility will ensure there is awake staff at night. LPA went over the importance to ensure the safety and for resident to be able to communicate and request assistance when needed. Smoke detectors and carbon monoxide detectors were tested and operational. The fire extinguisher located in the kitchen was observed charged and serviced June 8, 2023. Fire drill was conducted by the facility and documented on May 2023. There are auditory alerts on exit doors which were tested and functional. Water temperature in the resident bathrooms were tested and found to be within appropriate range of 105-120 degrees. Bathrooms have required non-skid surfaces and grab bars. Cleaning products and knives are stored in a locked cabinets in the kitchen. There is adequate space and furniture on the patio for outdoor activities. There was a 7 day supply of non-perishable foods. There are adequate dishes, glasses and silverware. There is a locked cabinet that stores residents' medications, staff and resident files. Continue report see LIC809-C Medication was reviewed and in compliance. LPA reviewed staff files and staff S1 did not have proof of current CPR/1st aid as it had expired May of 2023. Administrator certificate for Juliana Clarin #6022329740 expires 1/31/2025. Administrator and LPA discussed their Emergency Disaster Plan and Infection Control Plan. LPA went over Reporting Requirements and requested facility to go over the Hospice Waiver that is in place for the facility. The facility must must remain in substantial compliance with all terms and conditions of the waiver and notify the Department in writing within five working days of the initiation of hospice care services in the facility for any terminally ill resident. The notice must include the resident’s name, date of admission to the facility, and the name and address of the hospice. Licensee/Administrator to submit the current following documents by 8/21/2023: · LIC 308 Designation of Facility Responsibility · LIC 500 Personnel Report · LIC 400 Affidavit Regarding Client/Resident Cash Resources · LIC 610E Emergency Disaster Plan · LIC 9020 Register of Facility Residents Infection Control Plan of Operation (If changes) Copy of current Liability Insurance The following deficiencies were observed (see LIC 809-D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal of rights provided