Routine inspection·January 17, 2025

Licensing Program Analysts (LPAs), Stevenson and Felias arrived unannounced at Nene's Rest Home for the purpose of conducting a Required 1 year inspection. LPAs were greeted at the door by Administrator, Mary Jane Miranda, and was granted access into the facility. LPAs toured facility with Administrator and observed that the facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Fire Extinguishers were found to be last charged on February 2024. All smoke detectors and carbon monoxide detectors were tested and found to be operational during the inspection. First aid kit was inspected and found to be appropriate during the inspection. Facility sinks were measured at 137.1F, 135.5F, and 126.5F which is out of compliance with Title 22 Regulation (deficiency cited, LIC809D, regulation 87303(e)(2 )). LPAs discussed with Administrator about placing warning signs at sinks that are above 125F. There was sufficient perishable and non-perishable foods located in the kitchen. There are special provisions made for individuals with special dietary needs. Food menu was presently available for viewing during the inspection. Medications were centrally stored and locked. Cleaning products and other toxins are located under the kitchen sink and in the laundry room that was locked and inaccessible to residents in care. There was a supply of cleaners, hygiene products and paper products available for residents. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present. Resident bedrooms had lighting and appropriate furnishing. LPAs reviewed staff files, resident files, and resident medication. LPAs reviewed 4 staff files. During review, LPAs observed that Staff Member 1 (S1) had current first aid/CPR certification. Staff Member 2 (S2) only had CPR certification but not first aid. Staff Members 3 and 4 (S3 and S4) did not have current first aid/CPR certification as required (deficiency cited, LIC809D, Health and Safety Code, 1569.618(c)(3)). During review of resident files, LPAs observed that 2 of 3 residents were missing updated Needs and Services Plans/LIC625. Resident files were shown to have updated hospice care assessments. LPAs discussed the importance of having a facility care plan separate from the hospice care plan assessment (technical advisory issued, LIC9102, regulation 87463(i)). Continued on LIC809C Continued from LIC809 During visit, Administrator informed LPAs that during nighttime there is not a designated staff member awake to assist residents. LPAs informed Administrator that they are required to have at least one night staff person awake and on duty based on the size of their facility and the residents they serve (technical advisory issued, LIC9102, regulation 87705(b)(2)). LPAs obtained a copy of facility's most current LIC500 (Personnel Report). Administrator Certificate for Mary Jane Miranda (701663740) is current with an expiration date of 01/28/2025. Review of Department's Administrator Certification list indicated that Administrator renewal application had been received as of 12/23/2024. LPAs and Administrator discussed hospice waiver increases and hospice waiver exceptions. LPAs requested the following documents to be sent: LIC 500- Personnel Report LIC 308- Designation of Responsibility LIC 400- Affidavit regarding Client Cash Resources LIC9020 Register of Residents Updated facility sketch Updated Emergency Disaster Plan (LIC 610E) Most up-to-date Liability insurance Control of Property Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Exit interview conducted. Copy of report, LIC809D (Deficiency Page), LIC9102 (Technical Advisories/Violations), Confidential Names (LIC811), Plan of Corrections, and Appeal Rights discussed and provided to Administrator. Signature on form confirms receipt of documents.