Routine inspection·December 9, 2024

Licensing Program Analyst (LPA) Alviso arrived to conduct a required - 1 Year inspection, on 12/9/24 at approximately 9:55am. LPA was greeted by the caregivers that were on duty. Lead Caregiver Liza contacted the Administrator Arthur Alcones regarding the LPA's arrival to the facility. Administrator arrived within the hour to meet with the LPA. Facility has a required emergency disaster plan. Facility has a required infection control plan. Facility has an approved hospice waiver for three (3) residents only. Facility has an approved dementia plan of operation. Facility has a fire clearance for six (6) nonambulatory, of which two (2) may be bedridden. Only the four (4) front rooms can be used for bedridden. Facility has five (5) residents in care. Per record reviews, last emergency disaster drills were conducted on 10/22/24 and 9/3/24; LPA discussed the requirement of ensuring that one of the drills done quarterly is an evacuation drill. Administrator stated their understanding of the above and has an evacuation drill planned this December 2024. LPA toured the facility. Hot water was checked at 120. degrees Fahrenheit, which is within regulation. Administrator agreed to ensure the hot water is not above 120. degrees Fahrenheit and no lower than 105. degrees Fahrenheit. All fire extinguishers, two (2), were serviced and tagged as required. All smoke alarms were marked as working appropriately per inspection. All exit doors had auditory alarms on them. Food supply was sufficient. All medications were stored appropriately and locked up per regulations. All cleaners/disinfectants were locked up and inaccessible to residents in care. Sufficient supply of linens, paper products, furnishings, hygiene products, and personal protective equipment (PPE) for use by the facility. The facility was at a comfortable temperature. There was sufficient lighting for residents in all common areas, hallways, bathrooms, and resident rooms. Continued on LIC809C... LPA is requesting the following documents be updated and submitted by 1/9/25: 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 (include copy of surety bond if handling cash) Copy of Current Liability Insurance Resident Roster Copy of current Administrator Certificate . LPA reviewed five (5) resident files, including reviewing logs and medication storage. All files were complete, and all medications were stored appropriately. LPA reviewed four (4) staff files, including training. All staff had criminal record clearance as required. Staff had required training. Three (3) out of four (4) staff lacked first aid and cpr certification as required. The following deficiencies were observed during the inspection and will be cited: Per record reviews, three (3) out of four (4) staff lacked first aid as required. S3 is a direct caregiver, and is a staff that has been on their own working with residents in care. LPA observed this upon arriving to the facility today, 12/9/24. This deficiency will be cited, 87411(c )(1) Personnel Requirements – General- All RCFE staff who assist residents with personal activities of daily living shall receive initial and annual training as specified in Health and Safety Code sections 1569.625 and 1569.69 Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross, see LIC809D. California Code of Regulations, (Title 22, Division 6, Chapter 8), is being cited. Failu re to correct deficiency (s) by due date (s), may result in additional deficiency citations and/or civil penalties being assessed. Exit interview conducted with the Administrator Arthur Alcones. Appeal Rights Provided.