Routine inspection·December 15, 2023

Licensing Program Analyst (LPA) Cuadra conducted an unannounced Required - 1 Year annual inspection and met with Executive Director, Robert Rubio. There are currently 9 residents living in the Assisted Living (AL) portion of the facility and 83 residents living in the Independent Living (IL) portion of the community. There are residents with a diagnosis of dementia and no residents were receiving hospice care at the time of the visit. Required postings were observed. Facility contact information was reviewed. Fees are current at the time of visit. Beginning at 9:00 AM, LPA/Administrator toured assisted living portion of the community including the resident rooms/apartments, activity rooms, grounds and kitchen (located in the assisted living). All interior parts of the facility were found to be a comfortable temperature. Exits and pathways were free from obstructions. Hot water temperature measured between 112.8 and 113.4 F in faucets used by residents which is within regulation of 105 to 120 degrees F. LPA observed at least a minimum of a 2 day supply of perishable and 7 day supply of non-perishable food quantity and quality stored in a safe manner for residents in care and staff as well as an emergency food supply. Bathrooms contained necessary grab bars and non-slip floor/mats. Toxins were observed to be inaccessible in the Assisted Living portion of the community. Meals are prepared in the main kitchen and brought to the dining room in the AL portion of the community for residents living there. Medications are centrally stored in a locked office in the assisted living building. Fire extinguishers were current and charged as of October 2023. Fire alarm system was tested and inspected and documentation of last semi-annual inspection conducted on 11/29/2023 was provided during the visit. A disaster drill was conducted on September 2023. Carbon monoxide detectors were observed to be present and in working order. Continued on LIC809C... Continues from LIC809... LPA initiated file review at 10:00am nine resident and five staff records. Six out of nine residents (R1, R2, R3, R4, R5 & R6) care plans has not been updated within the last 12 months. One out of nine residents (R3) has not been updated within the last 12 months. Five staff records were reviewed. Staff have CPR/1st aid certificate. Two out of five staff (S1 & S2) does not have 20 hours of required annual training on file. A spot check of Medication and medication records was also conducted. Administrator Robert Rubio's Certificate 6054931740 expires 1/21/2024. Administrator agrees to submit the following documents updates to CCL by 12/22/2023: -LIC308 - Designation of Administrator Responsibility -LIC500 - Personnel Report -Updated Liability Insurance Certificate. -Control of property. -LIC610E - Emergency Disaster Plan & Updated Evacuation Plan Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview was conducted with Administrator and a copy of the report was given.