Routine inspection·December 5, 2024

Licensing Program Analyst (LPA) Coppo conducted an unannounced annual inspection and met with Administrator Robert Rubio. There are currently 10 residents living in the Assisted Living (AL) portion of the facility and 69 residents living in the Independent Living (IL) portion of the community. Two [2] residents were receiving hospice care at the time of the visit. Required postings were observed. At approximately 1:30pm LPA and Admin 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 119.7 and 109.5 degrees F 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-skid strips. Meals are prepared in the main kitchen and brought to the dining room in the AL portion of the community for residents living there. Fire extinguishers were current and charged as of 4/4/2024. Fire alarm system was tested and inspected by Santa Rosa Fire Equipment Inc on 4/22/24. Latest disaster drill was conducted on 9/3/24. At approximately 2:00pm LPA conducted a review of 10 resident records. Residents R1 and R2 did not have a TB clearance on file ( deficiency, cited, see 809D ) Continued on 809C... Continued from 809... At approximately 3:30pm LPA conducted review of 5 staff records. Staff members S1 and S2 did not have 20 hours of annual training completed. S1 had 7 hours and S2 had 10.5 hours ( deficiency cited, see 809D ) At approximately 4:15pm LPA and Admin conducted a spot check of medication and medication records. Medication is centrally stored in a locked room. No deficiencies Robert Rubio Administrator Certificate 7021430740 expires 1/21/26. LPA and Administrator discussed facility's Infection Control Plan and Emergency Disaster plan. No new updates. Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: LIC500- Personnel Report LIC308- Designation of Responsibility Liability Insurance Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Appeal rights given and discussed with Administrator. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Administrator and a copy of this report was given .