Routine inspection·July 25, 2023

Licensing Program Analyst (LPA), Farhaan Sarangi arrived unannounced at Yerba Buena Residential Care Home for the purpose of conducting a Required 1 year inspeciton. LPA was greeted at the door by Caregiver, Noel Marayag and was granted access into the facility. During a review of the Guardian Background Clearance Roster, LPA observed that 1 out of 2 staff members did not have a Background Clearance (See LIC 809D & Civil Penalty). Caregiver, Noel Marayag disclosed to the LPA that the Uncleared Adult just started working yesterday, July 24, 2023. LPA attempted to get Identification from the Uncleared Adult, but the Uncleared adult did not have any identification. While setting up the LPA laptop on the kitchen table, LPA observed a camera with audio in the kitchen credenza closest to the fridge monitoring a resident in placement (See LIC 9102-Technical Violation) . Caregiver disclosed that the camera was put in by the family. LPA advised to remove the camera. LPA gave Technical Assistance to the facility if the families want to install cameras in the room. LPA and Caregiver toured the facility. LPA observed the facility to be clean and at a comfortable temperature with all exits free from obstruction. Fire Extinguishers were found to be last charged on October 2022 at the time of the inspection. All smoke detectors and carbon monoxide detectors were tested and found to be operational during the inspection. Auditory Devices were operational during the inspection. First Aid kit cart was inspected and found to be appropriate during the inspection. Water temperature in 3 of 3 residents bathroom measured at 105 degrees and is within acceptable range of 105 to 120 degrees F. There was sufficient perishable and non-perishable foods located in the kitchen. Knives and other hazardous items were locked and inaccessible to residents in care. There are special provisions made for individuals with special dietary needs. Food menu was presently available for viewing during the inspection. Activities menu was available for viewing during the inspection. Medications were centrally stored and locked in the closet. Cleaning products and other toxins are located in the locked laundry room and inaccessible to residents in care. There was a supply of Linens, cleaners, hygiene products and paper products available for residents in care during the inspection. (Report continued on LIC 809C) All bathrooms designated for residents in the common areas at the facility were supplied with individual paper towels and hand soap. Bathrooms in resident’s rooms have a towel and soap. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present. A tour of all residents bedrooms were conducted, and bedrooms inspected have lighting and appropriate furnishing. Staff files, resident files and medication files will be reviewed at a later date and time. Staff and resident interviews will also be conducted at a later date and time. Emergency Disaster Plan was reviewed. Emergency Generator was observed in the garage. LPA advised facility to contact County Public Health and Community Care Licensing immediately if symptoms or COVID-19 + or any other infectious diseases in the facility. LPA discussed the Infection Control Plan with the Caregiver and advised to update Infection Control Plan. To update the Infection Control Plan, see below: https://www.cdss.ca.gov/ inforesources/forms-brochures /forms-alphabetic-list/i-l LIC 9282 (6/23) – Residential Infection Control Plan - Adult Residential Facilities, Enhanced Behavioral Supports Homes, Community Crisis Homes, Residential Care Facilities for the Elderly, Residential Care Facilities for the Chronically Ill, and Social Rehabilitation Facilities Emergency Disaster Plan was discussed. A review of the Emergency Disaster drill reflects the last time a drill was conducted was on March 2021 (See LIC 9102-Technical Violation). LPA educated the Caregiver regarding the importance of conducting quarterly disaster drills as outlined in Title 22 regulations. The following deficiencies were observed (See LIC 809D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Civil Penalty assessed (See LIC 421M dated for June 5, 2023) Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in additional civil penalties. Exit interview conducted with the Caregiver, appeal rights provided and Caregiver provided this report.