Routine inspection (multi-day)·June 8, 2023

Licensing Program Analyst (LPA) Alviso conducted a continuation of the Annual visit, on 6/8/23 at approximately 9:40am, and met with Administrator Maria Cortez. The Required Annual visit was started on 4/28/23, see report LIC809. Hospice care waiver approved for thirteen(13) residents. Facility has an approved dementia plan of operation. Facility has submitted the required Infection Control Plan, which is part of the facility's plan of operation. The facility does have a required emergency disaster plan, including emergency(s) and evacuation plan. Fire clearance approval is for 80 non-ambulatory residents, which includes 4 bedridden. LPA reviewed five(5) staff records. All staff have criminal record clearance as required by regulation. LPA reviewed staff training on file. Staff have required First Aid and CPR certification as required. Facility was observed to be clean, orderly, and at a comfortable temperature during today's visit. LPA observed exits free from obstruction. Fire extinguishers, twenty-two(22), were serviced and tagged as required- expires 2/21/24. All common areas, hallways, and bathrooms seen by the LPA were observed to have sufficient lighting. All stairwells, two(2) of them, had an evacuation chair with instructions of how to use the chair posted up as required. Emergency bonder was observed to be up front at the concierge desk area. The storage lock box with master keys to rooms and facility vehicles to be used in facility emergencies was observed in the mail/fax room on the first floor. The facility has emergency supplies, including food and water to meet requirements of the 72 hour shelter in place. The kitchen was observed to have a sufficient supply of perishable and non-perishable food. Facility has a sufficient supply of cleaners, hygiene items, PPE supply, and paper products. LPA observed the theater room to be clean and orderly, with a movie playing. Elevator was inspected and cleared on 6/5/23. facility waiting on new permit to post up in the elevator. Continued on LIC809C... LPA reviewed five(5) resident records. One(1) resident lacked an updated medical assessment as required by regulation, this will be cited, 87705(c)(5) Licensees who accept and retain residents with dementia shall be responsible for ensuring that each resident with dementia shall have an annual medical assessment as specified in Section 87458, Medical Assessment, and a reappraisal done at least annually, both of which shall include a reassessment of the resident’s dementia care needs, see LIC809D During the inspection the LPA observed that the beauty salon in assisted living was unlocked with no staff inside, this left poisons/chemicals, toxins, and other items in the salon, unlocked and accessible to residents in care. This is a violation and will be cited, 87309(a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients, see LIC809D. During the inspection the LPA observed that the hot water checked throughout the facility, 122.F, 121.5F, and 123.4F , this is not within regulation, and will cited, 87303(e)(2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F. and not more than 120 degree F., see LIC809D. During the inspection, the LPA observed that two large boxes of lentils was opened and lentils were not covered and stored appropriately, a large box of rice left open and was not covered and stored appropriately to protect the safety and acceptability necessary to prevent contamination; this deficiency will be cited, 87555(b)(9) Food service requirements shall apply: Procedures which protect the safety, acceptability and nutritive values of food shall be observed in food storage, preparation and service, see LIC809D. LPA obtained photos for the file. Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Appeal rights given to the Administrator.