Routine inspection·April 16, 2025

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a required Annual inspection and was greeted by caregiver. Administrators Maggie and Heherson Garcia arrived later. Maggie Garcia Administrator Certificate 7008481740 expires 5/5/2025. At approximately 9:30am LPA and Admin toured the building and grounds. Facility currently has six [6] residents in care, none of which are on hospice. LPA observed a noticeable order of incontinence upon entering facility ( deficiency cited, see 809D ). LPA observed items in bathroom such as storage rack and paper towel holder in bathroom to be dirty and dusty. The facility was found to be at a comfortable temperature. LPA observed camera to be present in the kitchen and in the common area living room. LPA asked to see notification and consent form signed by the residents' or residents' responsible parties for the cameras. Admin provided LPA a form with signatures, but none of the signatures matched the signatures of the residents or residents' responsible parties and the dates of the signatures is before many of the residents moved into the facility. LPA advised Admin to disclose and obtain the consent of residents and/or residents' responsible parties when utilizing video surveillance within the facility. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable food. Facility had fresh fruit but no fresh vegetables. Admin claims that today she was going to replenish the facility's supply of fresh vegetables, so Admin immediately went to store and purchased some fresh lettuce and vegetables. LPA observed opened bag of sugar and coffee in pantry without any seal or label. LPA advised to keep open items properly sealed after opening. Kitchen cabinet containing cleaning supplies was locked. Kitchen drawer with sharp knives locked. LPA observed a pair of scissors in unlocked kitchen drawer. LPA advised to keep objects that could present as a hazard to residents in locked drawer. Continued on 809... Continued from 809... All bedrooms were equipped with lighting, night stand, and chest of drawers. R1 and R2 do not have a comfortable mattress with good springs ( deficiency cited, see 809D ). R3 did not have a pillow. Admin claims R3 does not want a pillow. LPA advised to keep one out and available in case R3 does want a pillow. 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 110.4 and degrees F which is within the allowable range of 105 to 120 degrees F. Fire extinguishers were last inspected 1/13/25. Sprinklers and Smoke/Carbon Monoxide detectors located throughout the facility are hard wired and serviced by vendor. Last date of service January 2025. Facility’s last quarterly disaster drills were conducted March 2025. Facility has a backup generator for use during a power outage. LPA and Admin observed two boards on side of wrap around deck to bow when pressure is applied. On the same two boards there are nails that stick up, as they are not flush with the board, presenting a hazard to residents. Admin immediately hammered down nails and will replace boards or make them secure within one week. At approximately 11:45am LPA conducted a review of six [6] resident records. No deficiencies cited. LPA reviewed with Admins discrepancies found on residents' physician assessments. Admins will follow up and get corrections/clarifications to diagnoses and ambulatory status listed on residents' respective physician assessments. LPA observed R4's right eye to be very red and appears to be inflamed. Admin advised LPA that R4 just had a doctor visit on 2/28/25. However, eye issue was not addressed at visit per LPA review of discharge papers. Admin will have R4's eye looked at by their doctor as soon as possible. At approximately 1:00pm LPA conducted review of five [5] staff records. LPA reviewed training documentation forms created by the facility. Training records present do not list hours completed. LPA advised Admins that their documentation of training must include the hour duration of the training completed and the course topics covered. Currently, there is no hour duration listed except for shadowing hours or RCFE Initial training hours. However, staff initial training hours certificate does not list topics covered. LPA Continued on 809C(2)... Continued from 809C... reviewed training materials and observed three [3] items present for training: Paper materials and CDs dated 2008 from Community Care Options, videos from Community Care Options dated 2011, and a California Dementia Care Compliance book from Allen Flores dated 2025. LPA advised that training materials should be current, within the decade, and cover all the required subject topics per regulation, not just dementia but also hospice care, postural supports, and restricted conditions among other topics. LPA went over Health and Safety Code with Admins outlining the topics required and hours required. Additionally, LPA and Admins discussed either obtaining current materials and submitting them to CCL for approval or using an approved vendor. Admins decided to use the approved vendor of Community Care Options going forward. At approximately 2:45pm LPA and Admin conducted a spot check of medication and medication records. Medication is centrally stored in a locked cabinet. LPA found discrepancies with medication for R2 and R5. Pertaining to R5:Prescription Eliquis 5mg filled 3/19/25 count was off. Quantity of 60 bottle started on 3/19/25 and R2 is supposed to receive 2 tablets per day, but one pill left in the bottle. Prescription Levetiracetam 500mg count was off. Quantity of 120 bottle started 3/6/25 and R2 is supposed to receive 1 tab per day but 37 pills remain. Pertaining to R2: R2 had hydrocortisone prescribed on 3/6/25 but LPA did not observe the cream in R2's medication bin. Medication not listed as PRN on doctor's orders however, per Admin, medication was never filled and never added to Centrally Stored Medication Log ( deficiency cited. see 809D ). LPA discussed and offered Technical Support Program for medication management help from CCL. Admins declined offer and will reconcile medication records and medications on their own for now. 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 deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Administrators and a copy of this report was given .