Routine inspection·March 22, 2023

On 03/22/2023 at 1:00pm, Licensing Program Analyst (LPA) Arielle Pascua arrived to this facility unannounced to conduct an Annual Visit. LPA Pascua was greeted by Facility Designated Administrator (FDA) Guillermina Zepeda and explained the purpose of the visit. Current census was 30. A brief interview was conducted with FDA Zepeda. This facility is licensed for 31 residents, of which 25 may be non-ambulatory. LPA reviewed 6 resident files. 6 out of 6 resident files were current and up to date. LPA reviewed 6 staff files. 6 out of 6 staff files were current and up to date. The facility Administrator has an administrator certificate #6025364740 and is awaiting renewal from the department. LPA Pascua observed a locked centralized stored medication cabinet located in the office. Along with the staff member, the LPA observed, reviewed, and compared resident medication and electronic medication dispensing logs. First Aid Kit was present and contained all of the required components. A tour with FDA Zepeda was conducted. Fire extinguisher located throughout the facility. was serviced by U.S.A. Stanislaus Fire on 06/16/2022. Carbon monoxide, smoke detectors and call lights were observed to be in good repair. Dining areas, living areas, and all other areas intended for resident use were toured. It was observed that furniture and furnishings were sufficient and able to meet the needs of the residents at this time. Kitchen area was toured. LPA observed a sufficient amount of 2 day perishable and 7 day non-perishable food supply to meet the residents needs. Knives were observed to be locked and made inaccessible to the residents in care. Additional food supply was identified in an outside storage. A tour of the laundry room was conducted, laundry detergent, bleach and all other cleaning supplies were made inaccessible to the residents at this time. A tour of the resident bedrooms was conducted. Resident furniture was observed to be sufficient to meet the resident needs at this time. 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 tour of the second building was conducted. Dining areas, living areas, and all other areas intended for resident use were toured in this building. It was observed that furniture and furnishings were sufficient and able to meet the needs of the 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 Per California Code of Regulations, Title 22 Division 6, Chapter 8, one deficiency is being cited today in violation of California Code of Regulations. An exit interview was conducted, a copy of this report and appeals rights were provided to the Administrator at the end of this visit.