Routine inspection·September 21, 2022

On 09/21/2022 at 1:30pm, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct a infection control visit. LPA Pascua met with staff member, Ralph Feril and explained the purpose of this visit. LPA Pascua asked staff member, Feril to call the Administrator, Margaret Feril, to let her know that CCL is present at this time. This facility is licensed to hold 6 residents with a hospice waiver for 3. At 1:40pm, LPA Pascua initiated a tour of the facility with staff member, Ralph Feril. Current Census is 6. Administrator has a current certificate and expires on 12/05/2023. Fire extinguishers located in the kitchen and hallway have been inspected by Hayden Fire Protection on 07/15/2022. This facility has a central screening point and have a sufficient amount of PPE supply. The kitchen area was toured. LPA identified non-perishable and 2 days perishable food supply. Knives were observed to be locked in the kitchen cabinet and made inaccessible to the residents at this time. A medication cabinet was identified in the kitchen. LPA observed medication to be pre-poured from designed resident bottles to another medication dispenser. Staff member stated that this is easier for them to disperse medication. LPA Pascua advised staff member, Feril what the regulations are about pre-pouring medication. Along with the staff member, the LPA observed, reviewed, and compared resident medication and medication dispensing logs. First Aid Kit was present and contained all of the required components. A tour of the bathrooms was conducted. Hot water temperature was measured and observed to be within the required range of 105-120 degrees. A linen closet was located in the hallway and presented a sufficient amount of linens to adequately supply and meet the needs of the residents at this time. A tour of the bedrooms was conducted. Resident furniture was observed to be sufficient to meet their needs at this time. Common areas were toured. Living room, dining area and all other areas intended for resident use were observed to be furnished and maintained in compliance at this time. A tour of the garage was conducted. Additional non-perishable food supplies were identified. All cleaning supplies were locked and made inaccessible to residents at this time. The exterior of the physical plant was toured. Perimeter fence was observed to be stable and gates were in good repair. The following forms and documents were requested to be updated and submitted into CCL -LIC 308 -LIC 400 -LIC 500 -LIC 610 The following deficiencies were observed and cited on the following LIC 809-D pursuant to Title 22 Rules and Regulations, Health and Safety Code. Appeal rights were printed and a copy was given to the facility . Exit Interview.