Routine inspection·December 12, 2024

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a required Annual inspection and was greeted by Administrator Jeralyn May. At approximately 10:00am LPA toured the building and grounds. LPA toured kitchen. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable food. Some food items observed were not covered or not labeled with date of opening: chocolate mousse, cakes, and dishes of fruit, gallon of milk and white food item that looked like mashed potatoes or riced cauliflower ( deficiency cited, see 809D ). LPA observed box of lettuce and lettuce actively being used to prepare salads to have black wilted leaf tips and/or stalks. Some the the leaf tips were both black and had a white fuzzy substance present ( deficiency cited, see 809D) . LPA observed freezer temperature log to be missing temperature recordings for two AM shifts and one [1] PM shift, and the refrigerator temperature log was missing temperature recordings for three [3] PM shifts and five [5] AM shifts. All bedrooms in Memory Care buildings 1 and 2 were equipped with lighting, night stand, and chest of drawers. All bedrooms viewed in Assisted Living were also equipped with lighting, night stand, and chest of drawers. All bedrooms were clean and in good repair. Residents' main shower/bathroom in Memory Care building 1 had required grab bar but did not have non-skid mat or strips present. Water temperature in sink accessible to residents in care measured at 116.6 degrees F in the outer dining room kitchen sink and 114.2 degrees F in the internal dining room sink, 108.7 degrees F in room 302, 107.2 degrees F in room 101, and 107.4 degrees F in room G, all which are within the allowable range of 105 to 120 degrees F. Fire extinguishers were last inspected 3/12/24. Smoke/Carbon Monoxide detectors located throughout the facility and serviced by a vendor, last serviced on 11/19/24. Facility’s last quarterly disaster drills were conducted on 10/2024. Continued on 809C... Continued from 809... LPA observed the pendant call button system to not be properly working. LPA interviewed resident in room 101 (R2). LPA pressed resident's pendant at 11:34am. Staff (S1) arrived at 11:42am to room 101 to take the resident down for lunch. LPA asked caregiver if they were here to answer the pendant call, they said no, and explained that they did not receive a page and were here to take the resident to lunch. Care giver then proceeded to wheel the resident down to the dining area. Admin was approaching down the hall as S1 was leaving. LPA advised Admin of pendant alarm not working. LPA confirmed with Admin that pendant flashed red when LPA pressed it. The pendants flash red when they are activated then turn green once reset/answered by staff. The staff are to receive a page when the pendant is pushed and the call is also logged on the pendant/call button computer. Admin and LPA went to review computer call button log and there was no call showing from room 101. Admin went to resident in dining hall and pressed resident's pendant, S1 was present as well. Once again S1 did not receive the page and the call request was not logged on the call button computer log ( deficiency cited, see 809D ). At approximately 1:00pm LPA conducted a spot check of medication and medication records in Memory Care building 2. Medication is centrally stored in a locked cart in a locked room. LPA observed Olanzapine 2.5 mg prescription filled on 12/7/24 for R1 to be missing from the Centrally Stored Medication Log (CSML) ( deficiency cited, see 809D ). LPA conducted a review of 6 resident records. LPA conducted review of 5 staff records. S3, S4, S5 and S6 did not have current CPR on file ( deficiency cited, see 809D ). S4 and S6 do not have complete required training on file ( deficiency cited, see 809D ) Jeralyn May Administrator Certificate 7036260740 expires 11/14/25. Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: LIC500- Personnel Report and Liability Insurance Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Appeal rights given and discussed with Admin. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Administrator and a copy of this report was given .