Routine inspection·August 2, 2024

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a required Annual inspection and was greeted by caregiver. Administrator Kathleen Albano arrived later. Facility contact information was reviewed. At approximately 9:30am LPA and caregiver toured the building and grounds. The facility was found to be clean and at a comfortable temperature. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable food. Food in refrigerator had open items covered but not labeled with date of opening/storing. Food observations include: refrigerator drawer of radishes were covered in black substance and spots. Refrigerator drawer liner covered with black spots of a black substance and contained wilted and browning celery with brown liquid, and lemon and orange with white and blue fuzzy substance ( deficiency cited, see 809D ). LPA discussed with Admin their practice of freezing milk. LPA observed frozen milk to be stamped with a best if used by date that has expired by one day. LPA advised to keep fresh milk on hand or if they must freeze the milk to please defrost and use by best if used by date. Kitchen cabinet containing cleaning supplies was locked. Kitchen drawer with sharp knives locked. All bedrooms were equipped with lighting, night stand, and chest of drawers. All bedrooms were clean and in good repair. Extra hygiene products and linens were available. Resident bathroom had required bath mat and grab bar. Water temperature in sink accessible to residents in care measured at 106.8.and 111.3 degrees F which is within the allowable range of 105 to 120 degrees F. One [1] of two [2] main bathrooms had cabinet containing toxins not was locked but had locking function ( deficiency cited, see 809D ). LPA inspection of garage revealed a walled off storage room used as a sleeping area for staff and included fan, bed, and stereo. LPA advised Admin they can either submit a LIC200 with an updated facility sketch to CCL to request fire clearance for the room, or remove all items from that room and cease have any staff use it. Continued on 809C... Continued from 809... as a sleeping quarter. Admin chose to remove all items from storage room in garage and cease using it as a sleeping quarter. Admin to submit pictures of storage room with all personal sleeping items removed to CCL by 8/9/2024. Fire extinguishers were last inspected 9/21/2023. Smoke/Carbon Monoxide detectors located throughout the facility were operational. Facility’s last quarterly disaster drills were conducted 4/11/2024. LPA advised that emergency drills must be performed every quarter. Facility has a backup generator for use during a power outage. At approximately 11:00am LPA conducted a review of five [5] out of [5] resident records. R1 has diagnosis of dementia, but most recent physician's report dated 5/15/2023 did not have all pages present, last page with doctor signature line not present, the next most current physician's report dated 2020. R1's most recent appraisal dated 5/5/2023 ( deficiency cited, see 809D ). Half rails present on five [5] out of [5] resident beds, however none had doctor's order on file. At approximately 12:30pm LPA conducted review of 5 staff records. S1 did not have fingerprint clearance. Per Admin, S1 was present at the facility on 7/25/2024 and was in training. Per Guardian, the fingerprint clearance status of S1 is "in process," but not yet showing a clearance determination of eligible ( deficiency cited, see 809D ). LPA advised Admin that S1 may not be present at or working in the facility, whether training or working, until fingerprint clearance is obtained and Guardian shows S1 with a clearance determination of eligible. S2 did not have current training completed ( deficiency cited, see 809D ). S3 did not have a Health Screen on file, however TB clearance via chest xray was on file. At approximately 2:00pm LPA and Admin conducted a spot check of medication and medication records. Medication is centrally stored in a locked cabinet. No deficiencies cited. Administrator Kathleen Albano Administrator Certificate 7017523740 expires 6/7/2026. All fees are current as of this time. Continued on 809C(2)... Continued form 809C... 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 LIC308- Designation of Responsibility 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 Administrator. Failure to correct the deficiency and/or repeat deficiences within a 12 month period may result in civil penalties. Exit interview conducted with Administrator and a copy of this report was given .