Routine inspection·August 8, 2023

Licensing Program Analysts(LPAs) Alviso and Rummonds arrived unannounced to conduct a Required -1 Year visit, at approximately 9:30am on 8/8/23, and met with Administrator Erika Molina. Facility has an approved dementia plan of operation. There is an approved hospice waiver for three (3) residents. Facility has an emergency disaster plan as required. Facility has an infection control plan as required. Fire clearance is approved for six (6) non-ambulatory, which includes one(1) bedridden. All smoke alarms, 10, which are also carbon monoxide detectors, were working properly during the inspection. LPA observed a screening area by the front door to use as needed. LPAs' toured the facility. All exits were clear and unobstructed. All postings were up and visible to all as required. Fire extinguishers(3) were serviced and tagged as required- expires 6/11/24. Hot water was checked at 106.8F. Facility has a sufficient supply of personal protective equipment(PPE) for use as needed. Toxins are stored in locked cabinets, and the laundry room which contains cleaners and toxins was locked and inaccessible to residents in care. There was a sufficient supply of hygiene products, and paper products for use as needed. Medications were stored locked making them inaccessible to residents. All exit alarms were on exit doors and working properly. All bathrooms had grab bars, and non-slip mat/flooring for bathing as needed. LPA reviewed five(5) resident files. All files were complete. LPA reviewed five(5) staff files. All staff had criminal record clearance as required. Continued on LIC809C.... LPA is requesting the following documents be updated and submitted by 9/8/23: LIC308 - Designation of Administrator Responsibility LIC610E-Emergency Disaster Plan (ensure to provide all information in all boxes as required) Copy of LIC400 Handling of Client Cash Resources Copy of Current Liability Insurance Per LPA's record reviews, three(3) out of five(5) staff lacked proof of initial/ annual training, records were unclear regarding hours completed. This deficiency will be cited,87411( c) Personnel Requirements – General All RCFE staff who assist residents with personal activities of daily living shall receive initial and annual training as specified in Health and Safety Code sections 1569.625 and 1569.69, see LIC809D. Per LPA's record reviews, one(1) out of five(5) staff lacked current first aid certification as required. This deficiency will be cited,,87411( c)(1) Personnel Requirements – General Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross, see LIC809D. The following deficiencies were and cited from the California Code of Regulations, Title 22, Division 6, Chapter 8 of California Regulation. Failure to correct the deficiency(s) and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with the Licensee/Administrator. Appeal Rights provided to the Administrator.