Routine inspection·January 9, 2024

Licensing Program Analyst, (LPA) Cuadra, arrived unannounced to conduct an Annual Required Inspection and met with Erica Campos (Lead Staff). German Sinitsyn (Licensee) arrived later. One resident is receiving hospice services. Required postings were observed. Activity Calendars and Weekly Menus posted. LPA/Staff initiated a tour of the facility at 9:00 am and made the following observations: Facility was a comfortable temperature, well lit and passageways were free from obstructions. Residents were engaged in exercising activities during inspection. Resident rooms were furnished per regulation. Water temperature in bathrooms used by residents measured at 113.2, 105.1 and 106.2 degrees F which are all within allowable range of 105 to 120 degrees F. Extra hygiene products and linens were available. Bathrooms had required bath mats and grab bars. Closets containing cleaning supplies and other items that could pose a risk were locked. Facility has at least two days of perishable and one week of non-perishable foods. Containers were labeled and covered per regulation. Medications were centrally stored and locked in the medication room. Fire extinguishers were last inspected December, 2023. Facility has a centralized smoke alarm and sprinkler system that is maintained by a vendor. The most recent inspection was conducted January 2024. Carbon monoxide detector was tested and operational. Exit doors have auditory alerts that were functional at time of visit. Each resident has a pendant to alert staff if the resident needs assistance. Last Disaster Drill was conducted on 10/11/23. Facility provides transportation to residents to their medical appointments. Continues on LIC809C... Continued from LIC809... File review was initiated at 10:00 am. 5 staff files and 10 resident files were reviewed. Staff have required First Aid and CPR certificates and annual continuation training hours were complete. 10 out of 10 residents' medical assessments and care Plans were updated/signed by a responsible party as required per regulation. Administrator Certificate for Licensee/Administrator Aida Reznik, 6034483740, expires on 4/11/25. Medications and medication records were reviewed. A spot check of Medication and medication records was also conducted at 11:00am LPA/Licensee found medication count discrepancies in at least 4 different medications (Acetaminophen 500mg, Hydrocodone 5-325mg, Docusate SOD 250mg and Amlodipine 2.5mg) checked for resident (R6 & R10). Licensee stated that they have not had a pharmacy audit at least twice a year, LPA will issue a technical violation. Licensee/Administrator to submit updates of the following documents by 1/19/24: Designation of Administrative Resposibility (LIC308), Personnel Report (LIC500) & Liability Insurance Certificate. 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.