Routine inspection·June 19, 2024

On 6/19/2024, Licensing Program Analyst (LPA) Tobola conducted an unannounced Annual Required – 1 yr. inspection for this facility and was greeted by Administrator, Emmanuel Salas. The facility currently provides care for 6 residents, none of which are receiving hospice services and some of which with a diagnosis of dementia. LPA continued with a tour of the facility with Administrator, facility found to be clean and at a comfortable temperature with all exits free from obstruction. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguishers found to be purchased within the year and gauge is still within charged meter. Administrator will be purchasing new extinguishers in August 2024. Smoke and carbon monoxide detectors found throughout the facility, were tested and found to be functioning. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations, with food stored in the kitchen refrigerator found to have appropriate coverings. Staff provide residents with meals according to dietary restrictions with an ample amount of fresh and healthy foods observed. Cleaning supplies and other toxins are safely stored in locked cabinets in the laundry room, garage and under kitchen sinks, all of which were secured upon inspection. Sharps and other kitchen supplies that could pose danger if available to residents were found secured under kitchen cabinet. There was a supply of hygiene products and paper products available for residents. All resident’s bedrooms have lighting & appropriate furnishings and bedding items. Residents that were awake during the inspection were observed interacting with staff in the common area, outdoor patio and in their bedroom watching television or resting. The facility encourages regular family visits and utilizes outdoor areas for resident exercise and mobility. There are two emergency exits located in the backyard which were found to be unobstructed. There is an outdoor patio with shade and large outdoor space for residents to utilize with exits equipped with ramps for accessibility. Continued onto LIC809-C LPA conducted a sample file review for 3 residents and found needs & service plans and for two (2) residents in need of updating. In addition, LPA found that one (1) Physician's reports for resident with dementia is not in facility file. However, Administrator confirmed that the medical assessment was conducted in April 2024 and will be requesting the updated copy from the resident's family and placed on facility file. Technical Violations issued. Upon a spot check of medications, LPA found that two prescribed medications were not administered for resident due to resident leaving for day program before medications were given. Lastly, upon LPA observation and review of CCLD Guardian Background Check, LPA found that staff (I1) was not granted fingerprint clearance but observed working in the facility with residents in care. I1 was immediately removed from the facility and Administrator agrees to follow upon clearances and proper association guidelines. LPA requested the following documents be sent to CCL by COB 6/26/2024: 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 Control of Property/Rental Agreement Civil penalty issued under Title 22 Regulation 87355(d)(3) for a total of $100 due to staff not fingerprint cleared. Deficiency 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.