Routine inspection·December 10, 2024

Licensing Program Analysts (LPAs) Cuadra and Stevenson arrived unannounced to conduct an annual required – 1 yr. visit of the facility and met with Licensee/Administrator Rosauro Sabile. There are residents receiving hospice services and diagnostic of dementia. Required postings were observed. At approximate 11:30am LPA/Licensee observed that there are annual fees outstanding in the amount of $495. Licensee was provided with Pin number to make an online payment. LPAs/Licensee toured the facility at 11:45 AM, the facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Exits were equipped with auditory devices and all auditory devices were working properly. Fire Extinguisher was found to be last charged on January 2024. Smoke detectors and carbon monoxide detectors were found to be operational during the visit. Last disaster drills have not been conducted quarterly with the last one being conducted on 4/10/24. Hot water temperature measured 110.3 and 110 which is within Title 22 regulation. There was a sufficient supply of both perishable and nonperishable food as required by Title 22 Regulations. Food stored in the kitchen refrigerator were properly stored as per regulations. Toxins are stored in a locked cabinet in the kitchen. There was a supply of cleaners, hygiene products and paper products available for residents. All bedrooms have lighting & appropriate furnishings. Contact information was reviewed. The facility does not handle cash resources. The bathrooms designated for residents at the facility were supplied with paper towels and hand soap dispensers. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present in the bathroom shower. However, one out of three sinks in the main bathroom located in the hallway had a sign of "out of order". Also, LPAs/Licensee observed that garbage cans located in the bathrooms did not have tight-fitting covers in the containers. Licensee agreed to repair needed items. LPAs/Licensee observed some deck boards needed to be replaced. Continued on LIC809C... Continued from LIC809... LPAs initiated file review at 12:00pm. Three resident's files and three staff files were reviewed. All residents have current medical assessments, but one out of three resident's pre-appraisal assessment have not been completed (technical violation was issued). One out three staff do not have additional 20 hours of training complete. Two out of three staff needs to update their 1st aid/CPR certificates. Administrator certificate for Administrator Rosauro Sabile #7011753740 expired on 5/2024. LPAs have reviewed the Department's certification unit list and found that the administrator is listed in the pending list. Medication and medication records were reviewed. Licensee agreed to submit updates of the following documents by 12/20/24: LIC 308 Designated of facility responsibility, LIC 500 Personnel Summary, LIC 610 Emergency Disaster Plan – if changes, copy of Certificate of Liability Insurance and proof of control of property. Deficiencies 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. Exit interview was conducted with Licensee and a copy of this report was given.