Non-compliance follow-up·May 19, 2021

Licensing Program Analyst (LPA) A. Canela conducted a case management- Legal/Non-compliance inspection, on 5/19/2021, at approximately 10:30 AM. LPA met with Licensee, Cecilia Ganzon. This inspection is being completed to ensure compliance with Non-Compliance Conference dated 11/5/2020. LPA toured the facility with the facility Administrator and the following was observed: All staff working today were observed wearing mouth coverings. There is an entrance table with PPE supplies and staff screened LPA upon arrival. LPA tested the water temperature in 3 bathrooms and all were within the required regulation of 105-120 degrees F. First bathroom tested at 117.5, second bathroom tested at 116.5 and the third bathroom tested at 116.7; all three bathrooms are located in the hallway and used by residents. LPA went in all 9 resident bedrooms of the first level of the home and resident rooms were found free of odors as requested in non-compliance plan by CCL for the facility to ensure the facility remains free of odors from incontinence. Non-compliance plan also addressed complinace with auditory alarms, maintenace and operation and staff required yearly training. During inspection of auditory alarms of the facility, LPA found 3 out of 8 doors with the auditory alarm not operational during inspection. The alarm on the rear exit of the facility had been turned off. Facility staff explained, residents may have turned it off when they went to the outside patio. 2 resident rooms were also found with the auditory alarm not working or turned off. Non-compliance plan requested facility to ensure auditory alarms are operational as the facility serves residents with Dementia diagnoses. LPA went over facilities Maintenance & Operation and found areas in the backyard patio and decking that will need attention and corrected. Some of the wood is beginning to rot and they may be a potential hazard for residents in care, facility shall be in good repair at all times in accordance with regulation. See LIC9099-C for continued report LPA reviewed staff training records and found all of the six staff working today, to have the required yearly training, including current proof of CPR/First aid. LPA discussed facility alert system and/or hand held bells for residents to use when they need assistance. LPA also requested facility to submit additional physician paperwork regarding resident R1's ambulatory status. Reports to be submitted to LPA canela by 5/23/21 for review. LPA consulted facility regarding regarding Deficiencies are cited from the California Code of Regulations (CCRs), Title 22, Division 6, Chapter 8 and the Health and Safety Code. Failure to correct the cited deficiency, on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Appeal rights and report will be emailed today to facility, due to technical issues. See 809-D for deficiencies cited