Routine inspection·May 30, 2024

At approximately 9:40 AM, Licensing Program Analyst (LPA) Stefanie Mutialu made an unannounced annual required inspection of this licensed senior care facility. LPA was greeted by caregiver, Jocelynn Leano. Administrator, Imee Villegas arrived shortly after at approximately 10:00 AM. The facility is a single story home licensed for six (6) non-ambulatory residents and a hospice waiver capacity of three (3). The facility currently provides care for 6 residents. Four out of six residents were at home, one out of six residents is in the hospital, and one out of six residents was out for a doctors appointment. In addition, there are some residents with a diagnosis of dementia and one patient using oxygen At approximately 10:15 AM, LPA and administrator toured the building and grounds which was found to be clean and in good repair. LPA observed broken and cracked tile on the front walkway. Per Administrator has a quote and has contacted landlord to get repaired. LPA observed all walkways and exits to be unobstructed. All notices that are required to be posted have been posted and are in a highly visible area. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. LPA observed several food items in the refrigerator, freezer, and cabinets that were not properly stored, expired, perishable items not refrigerated, and frozen food that showed signs of freezer burn. Per Administrator most food is staff and will ensure food is properly labeled and stored moving forward. Medication was found in the refrigerator, per Administrator medication refrigerator is broken but is getting repaired today at Best Buy. LPA advised Administrator to get a lock box to store medication in the refrigerator and will need to come up with food storage and labelling system/program. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Facility does not have back-up water supply for six residents for 72 hours in case of emergency. Administrator advised will pick-up water supply today and provide proof. Toxins are stored in a locked cabinet in the facility laundry room and kitchen. Sharps and other kitchen supplies that could pose danger if available to residents were found secured in the kitchen drawer. There was a supply of cleaners, hygiene products and paper products available for residents. All resident’s bedrooms have lighting & appropriate furnishings. Continued on 809C Continued from 809 Water temperature measured within regulation between 108.3 and 113.9 degrees F at two of three faucets accessible to residents. One out of one fire extinguisher was inspected and charged. Five out of five Smoke detectors were present and centralized signal system will lights are present. Carbon Monoxide detector was present, inspected and found to be in working order. There was enough lighting in all common areas, resident rooms, and hallways. Medications located in designated cabinet were found to be secured. LPA conducted a spot check of medications and found administering and records to be inaccurate. Resident was observed interacting with staff in bedroom and living room. Two of four residents were found in their room. Two of four residents were watching. LPA observed staff checking and caring for residents often. There are puzzles and games along with morning activities such morning exercises, karaoke, and card to keep residents engaged At approximately 11:00 AM, LPA reviewed Five of Six resident records which were all found to be well organized. One out of six residents files is over due for LIC602 Physicians Report. LPA advised administrator LIC602 is required annually for residents with dementia. Several client records reflected other facility. LPA advised administrator all clients records need to be update to reflect Art of Home facility. At approximately 12:00 PM , LPA reviewed one out of three staff records which were all found to be well organized. staff records missing for two out of three staff. One of three staff records did not contain required annual training for RCFE and Dementia training and First- Aid/CPR/BLS expired as of 03/2024. LPA advised Administrator to provide CCL with a copy of two out of three staff files and proof of completed required training to also include annual Dementia training and current First-Aid certificate. Medication records contained physician's orders for each resident. Administrator Imee Villegas Administrator Certification 6030808740i current and expires on 06/09/2024. Continued on 809C Continued from 809C Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: LIC 500 Personnel Summary LIC 9020 Register of Facility Client’s/Resident's Staff Training Files/Records Updated 602s LIC610E- Disaster Plan (updated with non-local evacuation site) Evidence of Liability Insurance 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. This report was reviewed with Imee Villegas and Appeal rights were given.