Routine inspection·September 28, 2023

Licensing Program Analysts (LPA) Cuarda and Coppo conducted an unannounced Annual Required – 1 yr. and was welcomed by Aaron Salvador Caregiver. Administrator Arthur Alcones arrived shortly after. There were 6 residents present at the facility with 1 resident on hospice. Required postings observed. LPA toured the facility around 9:15 am with Administrator Arthur Alcones. During tour on 9/28/2023 facility was found to be clean and at a comfortable temperature with all exits free from obstruction. At around 9:30 am LPAs/Administrator observed that back deck has wood scrap piles with nails protruding. Administrator explained that they are remodeling and the pile of wood waste is temporary. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguishers were found to be last charged on 9/15/23 at the time of the visit. Smoke Detectors & Carbon monoxide detectors were found to be operational during the visit. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Last disaster drill was conducted on 09/06/2023. Medications and medication records were reviewed. Hot water temperature; it measured 118.7 degrees F which is within acceptable regulations of 105 to 120 degrees F in 1 out of 2 resident’s bathroom faucets. There was a supply of cleaners, hygiene products and paper products available for residents. All resident’s bedrooms have lighting & appropriate furnishings. Toxins are secured and inaccessible in locked garage cabinets. Based on interviews with residents and LPAs/Administrator observation there are some discrepancies with statements obtained from residents about the facility providing limited activities for them. LPAs/Administrator had a conversation about the importance to provide a variety of activities for residents in care. Administrator agreed to review and develop a current activity calendar. LPAs will be issuing a technical advisory. At approximate 10:00 am LPAs initiated file review. One out of six residents physician's report (R2) was not updated and five out of six residents' (R1, R2, R3, R4 & R5) care plans were not updated within the last 12 months as stated per regulations. Continues on LIC809C... Continued from LIC809... During file review, LPAs/Administrator observed that two out of six residents (R3 & R5) physician's report stated that residents have a non-amb/bedridden status. Based upon interviews with residents, it was revealed that both are able to reposition on their sides without assistance. However, LPAs are instructing Administrator to obtain an updated physician's report clarifying status. LPAs discussed with Administrator process of fire clearance notifications including Fire Department and CCL regarding any bedridden status. Administrator agreed to submit the following current documents by 10/12/2023: LIC500 Personnel Report, LIC308 Designation of facility responsibility, control of property, liability insurance and Infection Control 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 Licensee and a copy of this report was provided.