Routine inspection·January 23, 2024

On 1/23/2024, Licensing Program Analyst (LPA) Tobola conducted an unannounced Annual Required – 1 yr. inspection for this facility and was greeted by Administrator, Romeo Cabe. The facility currently provides care for 5 residents, 3 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 was 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 throughout the facility to be last charged on 8/29/2023 at the time of visit. Both smoke detectors and carbon monoxide detectors throughout the facility were also 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 labeling. Toxins are stored in a locked cabinet in the facility laundry room, under kitchen sink and garage all of which were secured upon inspection. 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 hygiene products and paper products available for residents. All resident’s bedrooms have lighting & appropriate furnishings. Water was measured at faucets accessible to residents and measured between 112.8 and 115.7 degrees F which is within regulation. During inspection LPA observed several surveillance cameras located in common areas and hallways, none of which record audio. One camera was observed to be facing a resident bedroom. LPA requested for Administrator to reposition or remove the camera as a potential personal rights risk to resident. Technical Advisory issued. Continued onto LIC809-C Medications located in designated closet located in the hallway were found to be secured. LPA conducted a spot check of medications and found all administering and records to be in order. Resident medications are all delivered directly to the facility from the pharmacy. Residents that were awake during the inspection were observed interacting with staff in the common area, watching television for leisure. The facility also offers regular family visits and gatherings as well as encouraging residents to exercise their mobility. There is one emergency exit located in the backyard which was found to be unobstructed. All auditory alarms leading out of the facility including resident bedroom emergency exits were tested and all found to be in working order. Residents utilizing hospital bed or bed rails were found to have appropriate medical orders on file. In addition, signage for use of oxygen were posted at each door of residents requiring the use. Staff quarters were located in the backyard and have been cleared by the fire department for staff to reside. LPA conducted a sample file review for staff and found all staff to have appropriate annual training and 1st Aid & CPR certification on file. LPA also conducted a file review for all residents. Upon review, LPA found that all resident Needs & Service Plans and Physician's Reports to be current. Administrator, Romeo Cabe's Administrator Certification 6026462740 is valid through 6/14/2025. LPA requested the following documents be sent to CCL by COB 2/6/2024: 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 (may be submitted after 2/6/2024, due to renewal) Control of Property/Rental Agreement No deficiencies cited during today's visit.