Routine inspection·January 14, 2025

Licensing Program Analysts, (LPAs) Cuadra and Frank arrived unannounced to conduct an Annual Required Inspection and met with Maritza Pray, Back up Administrator and Aida Reznik, Licensee arrived later. Upon LPA's arrival a cart containing cleaning supplies and other items that could pose a risk were observed unattended on the hallway. LPAs inquired with staff and were told that staff was cleaning that part of the facility. However, it took staff ten minutes to come back to take the cart away. LPA/Licensee initiated a tour of the facility at 9:30 am and made the following observations: Facility was a comfortable temperature, well lit and passageways were free from obstructions. Resident rooms were furnished per regulation. There was a portable heater in 1 out of 5 rooms inspected. Per Licensee, the room is shared by two residents who have different preferences regarding the temperature of the room (technical violation issued). Water temperature in bathrooms used by residents measured at 111.2, 114.8 and 114.9 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. However, bathroom's garbage cans do not have well-fitted covers to prevent the spread of any communicable disease (technical violation issued). Facility has at least two days of perishable and one week of non-perishable foods. LPA/Licensee observed that kitchen outside door did not have a screen door to prevent insects and have a conversation with Licensee regarding door screen needed to be installed in the kitchen outside door (technical violation issued). Medications were centrally stored and locked in the medication room. Activity Calendars and Weekly Menus posted. Required postings observed. Annual fees are current. Fire extinguishers were last inspected December 21, 2023. Facility has a centralized smoke alarm and sprinkler system that is maintained by a vendor. The most recent inspection was conducted December 11, 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 December 5, 2024. Continues on LIC809C... Continued from LIC809...File review was initiated at 10:00 am. 5 staff files and 5 resident files were reviewed. Staff have required First Aid and CPR certificates and annual continuation training hours were complete. All 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. During file review, it was revealed that two staff (S1 and S2) were cleared, but they were not associated to the facility, LPA informed Licensee that both staff should never be working and providing care to residents prior to a criminal record clearance or exemption. Civil penalties are being assessed in the amount of $200 for allowing a person to work, reside or volunteer in the facility without a been associated to the facility. Medications and medication records were reviewed. A spot check of Medication and medication records was also conducted at 10:30am LPA/staff observed a loose tablet was found in the container of resident's (R1) medication. Administrator will review medication and their records and will conduct a staff training. Licensee provided the latest pharmacy audit dated December 2024. During today's visit, LPAs followed up on an incident report submitted to CCL notifying that resident (R3) on 12/30/24 around 1:11am was threatening to call the police on staff, pushing call button non stop, every time staff would answer their calls, R3 pretended that they were sleeping until 5am. R3 called the paramedics, when they arrived it was observed R1 being aggressive, throwing things at staff and paramedics took R3 on 5150. The facility notified R3's responsible parties. According to the Administrator, R3 is currently in the hospital receiving treatment and after their evaluation, it was determined that R3 needs to be relocated in a higher level of care. They are currently working on adequate placement for the resident's care needs to be met. Licensee/Administrator to submit updates of the following documents by 1/24/25: Designation of Administrative Resposibility (LIC308) & 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.