Routine inspection·September 16, 2024

Licensing Program Analyst (LPA) Alviso conducted a Required- 1 Year visit, on 9/16/24 at approximately 12:35pm, and met with Licensee/Administrator Heherson Garcia. Maggie Garcia, and Rosa Portillo, caregivers, were observed to be on duty upon LPA's arrival. There are currently five (5) residents in care. Facility has a fire clearance approval for a total of six non-ambulatory. Hospice waiver approval for two (2) residents. Facility has a dementia plan of operation. Al exits were free and clear of obstruction. Fire extinguishers, two(2), were serviced and tagged as required. Facility had all required smoke alarms, including a carbon monoxide detector. There was a sufficient supply of hygiene products, cleaning supplies, and paper products for use as needed. All bathrooms had grab bars, and all showers had non-slip mat/flooring for use as needed. Facility has a sufficient supply of personal protective equipment (PPE). LPA observed sufficient supply of food, perishable and non-perishable. Facility had sufficient furnishings for residents in care. Facility has sufficient lighting in all resident rooms, bathrooms, hallways, and common areas. Toxins/cleaners were locked up making them inaccessible to residents in care. Facility had linens for residents use. The backyard has outside patio furnishings for resident use, including areas providing shade for residents as needed. LPA reviewed five (5) resident files; LPA reviewed three (3) staff files. LPA reviewed staff training. All staff had current First Aid and CPR Certification. Continued on LIC809C.... LPA is requesting the following documents be updated and submitted by 10/16/24: LIC308 - Designation of Administrator Responsibility LIC500 - Personnel Report LIC610E-Emergency Disaster Plan (ensure to review and update as needed/required) Infection Control Plan- (ensure to review and update as needed/required) Copy of LIC400 Handling of Client Cash Resources (must complete form, include copy of surety bond if handling cash) Copy of Current Liability Insurance Resident Roster Copy of current Administrator Certificate The following deficiencies were observed during the inspection: LPA observed resident medications stored in open area on two refrigerator shelves, allowing the medications to be accessible to others/residents; Licensee/Administrator Heherson Garcia stated they were injectable medications/medications of a resident (resident (R1) LPA observed the kitchen cabinet where all other resident medications were being stored was observed to have a lock hanging off it but not secured closed/locked, allowing all medications to be accessible to all others/residents. This deficiency will be cited, 87465(h)(2) Incidental Medical and Dental Care- Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication, see LIC809D. LPA obtained photos. LPA observed that washcloths were hanging on the bathroom towel bars for resident use in two resident bathrooms that are shared; LPA observed two showering scrubbers in the shower caddy, both were well worn, and used for residents. LPA discussed having sufficient supply of washcloths/linens that can be used and put to wash to ensure sanitary conditions for residents and their hygiene care at all times. LPA observed that the bathrooms didn’t have paper towels for resident use to help ensure sanitary hygiene care for all residents. Administrator put paper towels in the bathrooms. This deficiency will be cited, 87307(a)(3)(C) Personal Accommodations and Services- The use of common wash cloths and towels shall be prohibited, see LIC809D. LPA obtained photos. Continued on LIC809C.... LPA observed that a residents room had a pad that had been used as it had dried urine stains visible on it. This deficiency will be cited, Managed Incontinence 87625(a)(1)(D) The licensee shall be permitted to accept or retain a resident who has a manageable bowel and/or bladder incontinence condition under the following circumstances: The condition can be managed with any of the following: The use of incontinent care products, see LIC809D. LPA obtained photos. Per file review, one out of three staff files lacked required training per health & safety code. Licensee /Administrator could not provide the LPA proof of S3's required training. This deficiency will be cited- 1HSC 569.625(b)(1) (1) This training shall consist of 40 hours of training. A staff member shall complete 20 hours, including six hours specific to dementia care, as required by subdivision (a) of Section 1569.626 and four hours specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696, before working independently with residents. The remaining 20 hours shall include six hours specific to dementia care and shall be completed within the first four weeks of employment, see LIC809D. Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Appeal rights given to the Administrator. Exit interview conducted with Licensee/Administrator Heherson Garcia