Routine inspection·July 17, 2024

At approximately 9:30 AM, Licensing Program Analyst (LPA) Julie Florio arrived unannounced to conduct a 1-Year Required Visit and Non-Compliance (NCC) quarterly visit and was greeted by Ramil Gilbert "Chinchin" Razon, Caregiver/Designated Responsible Party . Imelda Padama, Licensee was contacted via phone and arrived shortly after and Samuel Padama, Licensee arrived approximately 2 hours later. LPA was informed there are three (3) residents in care and all were present during inspection. Facility is a Residential Care Facility for the Elderly (RCFE) with a Hospice waiver for two (2), an approved dementia plan, and fire clearance for capacity of six (6) residents; five (5) non-ambulatory and one (1) bedridden. At approximately 9:45 AM, LPA initiated a tour of the facility and observed the following: Facility is a one story home, was a comfortable temperature, and passageways were free from obstructions. Water temperature in clients' bathrooms measured within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed client showers with grab bars an non-slip mats as required. LPA observed a supply of clean linens, incontinent care products, and paper products available to clients. Clients' bedrooms were inspected and observed to have appropriate furnishings as outlined in Title 22 regulations. Cabinets in communal areas of the facility containing cleaning supplies and other items that could pose a risk were observed locked. However, LPA observed toxic chemicals in the unlocked garage and outdoor storage building. Licensee removed and secured the items immediately making them inaccessible to residents in care. Facility has at least two days of perishable foods and one week of non-perishable foods. Medications were centrally stored and locked. There is outdoor space for activities. LPA observed an activity schedule and games available for resident use. Facility has two fire extinguishers, which were last inspected July 2024 and are fully charged. Smoke and Carbon Monoxide detectors were tested and operational during inspection. Continued on 809-C... Continued from LIC 809... Facility conducts yearly disaster drills, and the most recent drill was conducted July 2023. LPA informed Licensees, per Title 22 regulation, disaster drills shall be conducted on a quarterly basis. LPA observed the facility's infection control plan, first aid kit, PPE, other emergency supplies, and a back-up generator. There was no emergency water supply present as required per regulation. LPA informed Licensees that they shall purchase water to bring the facility into compliance. LPA reviewed facility's emergency disaster plan last updated April 2023. At approximately 11:00 AM, five (5) staff files and three (3) resident files were reviewed. All staff files reviewed have the required CPR and First Aid training certificates, as well as documentation of all required initial training hours. Two (2) of five (5) staff files reviewed were missing proof of required annual training and annual medication training. LPA provided Licensees a copy of sections 1569.625 and 1569.69 from the California Health and Safety Code as is pertains to required staff annual and annual medication training in RCFEs. This is a repeat violation within a 12-month period. LPA cited California Code of Regulations, Title 22, Division 6, Section 871411(c) and issued civil penalties in the amount of $250. LPA advised Licensees to ensure all required documentation is in staff files and available for inspection upon request. LPA observed two (2) of three (3) resident files missing a signed Individual Service Plan as required per regulation and cited (see LIC809D). LPA observed all remaining required documentation present in all resident files prior to conclusion of today's inspection. Licensee states residents' families coordinate and arrange transportation to and from their medical and dental appointments. Facility does not manage cash resources for residents. LPA reviewed facility's medications and medication records which are not maintained in compliance with regulation, resulting in LPA issuing a citation (see LIC809-D). Updated copies of the following documents are to be submitted to CCL within 30 days of this visit : LIC610- Emergency Disaster Plan 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, or repeat violations, may result in a civil penalty assessment. Appeal rights provided to Licensee. Exit interview conducted with Licensee, whose signature on this document confirms receipt .