Routine inspection·April 18, 2024

Licensing Program Analysts (LPAs) Florio and Cuadra arrived unannounced to conduct the required 1-year annual inspection. LPAs met with LIsa DiBartolo, Assistant Administrator and Alex Varshavsky, Licensee arrived shortly after. The facility has residents receiving hospice services and residents with Dementia diagnoses . LPAs observed residents were not participating in any activities. LPAs/Licensee toured the facility inside and outside at approximate 9am: The facility is a one story building and has an approved fire clearance dated November 16, 2022 that allows for 28 non-ambulatory residents and 6 bedridden resident. Fire Extinguishers were last serviced February 2024. Facility has a centralized fire alarm system that is maintained by a vendor and inspected by the local fire department. Facility's last maintenance was conducted 2/14/24. Facility has a locked perimeter. Smoke detectors, sprinklers, carbon monoxide detectors were present throughout the facility. LPAs pulled emergency alerts in residents rooms and staff responded in a timely manner. Fire panel was last inspected 02/14/2024. Last disaster drill was conducted on 03/14/24. Facility had sufficient perishable and non-perishable food. Annual fees are current. At approximate 9:30am LPAs/Licensee observed in communal area and in one resident bedroom, there was a wheel chair stored in front of sliding glass door, obstructing the exit. This poses an immediate safety risk to residents in care. As a result of the fire clearance violation, an immediate civil penalty in the amount of $500 is issued today. At approximate 9:45am LPAs/Licensee observed auditory emergency signal system not working or lacking in 4 out of the 12 client bedrooms inspected. Also, auditory alarms on several resident bedroom sliding glass door exits were not activated. Continue on LIC809C... Continued from LIC809... At approximate 10:00am LPAs/Licensee measured and observed hot water in one resident bedroom tested was 131.6 F, which poses an immediate risk of injury or harm to the residents in that room. At approximate 10:15am LPAs/Licensee observed 2 rusty shower chairs, holes in resident bedroom screen, 2 faucets broken in resident bedrooms, urine smell in resident room, ceiling fans observed covered with thick layer of dust, cement ramp not flush with cement walkway where residents walk, sticky floors in dining area, trash cans without lids/covers, lights not working, and broken electrical plate in resident room. At approximate 10:30am LPAs/Licensee had a discussion regarding activities not occurring during scheduled times. LPAs/Licensee observed posted a current activity schedule. LPAs inquired the reasons for the lack of activity, and were told by administrator assistant that the staff person responsible for conducting the activity was assisting residents. LPAs suggested to designated a back up staff to ensure activity scheduled occurred as planned as stated per regulation. At approximate 10:45 am LPAs/Licensee observed expired canned goods, unpacked dry good not with expiration dates noted, and uncovered prepared foods in the walk-in refrigerator. At approximate 11am LPAs/Licensee observed no menus posted for residents to view. LPAs asked to review a month worth of menus. The administrator did not currently have 30 days of planned menus dated on file. LPAs informed Administrator that per regulation, they shall have menus created and posted two weeks in advance for residents to view in a conspicuous place in facility communal area. At approximate 11:15am LPAs/Licensee observed storage cabinets containing potentially toxic chemicals unlocked in two communal restrooms. Aerosol hair products in drawer were observed in communal area and readily accessible to residents. Additionally, the laundry room door was observed unlocked and unattended with cleaning and laundry chemicals readily accessible to residents in care. Continue on LIC809C... Continued from LIC809C... At approximate 11:30am LPAs/Licensee observed toilet paper and paper towels not available to clients in some client bedrooms and community bathrooms. Lamps and chairs not observed in several client bedroom. Trash cans in common area and in resident bathrooms were observed with no lids/covers on them, one of which had a used bed pad inside. CCL reporting poster not observed in the facility. LPAs Informed Licensee one shall be posted in a conspicuous place in the main entry area of the facility for residents and visitors to reference. Technical violations will be issued. LPAs initiated file review at 12pm. Five residents and five staff files were reviewed. 4 out of five residents (R1, R2, R3 and R4) needs their care plan to be updated. All five medical assessments were updated. 3 out of 5 staff (S1, S2, S3) do not have annual required training hours completed. At least one staff per shift have current CPR. Administrator certificate for administrator Alex Varshavsky 6052513740 expires 7/15/24. At approximately 12:30 a spot check of medications were conducted and 4 out 5 residents (R1, R2, R3 & R4) medications were not given to residents according to their physician's order. Licensee to submit updates of the following documents by 4/25/24: Designation of Administrative Responsibility (LIC308), Personnel Report (LIC500), Emergency Disaster Plan (LIC610E), control of property and a copy of Liability Insurance. Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. As a result of the fire clearance violation, an immediate civil penalty in the amount of $500 is issued today. Exit interview was conducted with Administrative assistant who was informed that the Department will be reviewing if further action is needed to address the overall compliance of the facility and a copy of this report was given.