Routine inspection·October 17, 2023

On 10/17/2023 Licensing Program Analyst (LPA) Arielle Pascua arrived at this facility unannounced to conduct an annual infection control visit. LPA Pascua was greeted by staff member, Kenroy Anderson and was asked to call the Licensee, Marinela Placintar to let her know that licensing was present at this time. Shortly after, LPA Pascua met with Licensee Placintar explained the purpose of the visit. The purpose of the visit is to conduct an annual infection control visit. This facility has a hospice waiver for 2 and a dementia program on file. There was one other staff member present in the facility at this time, Antonieta Gimeno. This facility has a hospice waiver for 2 and a dementia program on file. Upon arrival, LPA Pascua learned that there are currently 3 residents on hospice at this time. LPA reviewed facility records which confirmed that there are 3 residents on hospice. LPA reviewed 3 resident files and 2 staff files. The Facility Designated Administrator does not have a current administrator certificate, however, has sent the department the proper documentation prior to the certificate expiring. LPA Pascua toured resident bedroom #1. Resident furniture was observed to be sufficient to meet their needs at this time. LPA Pascua also toured a bathroom connected to resident bedroom #1. Hot water temperature was measured to be 112 degrees. Grab bars were observed to be stable and in good repair 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. LPA Pascua toured the kitchen area. LPA Pascua observed a sufficient amount of 2-day perishable food supply in the refrigerator and a 7-day non-perishable food supply in the pantry for 5 residents. Knives were observed to be locked and made inaccessible to the residents at this time. Cleaning supplies were also observed to be locked under the kitchen sink and made inaccessible to the residents in care. A fire extinguisher was also observed to be in the kitchen and was annually inspected by Jorgenson Co on 03/18/2022. LPA Pascua observed a locked centralized stored medication cabinet located in the kitchen. Along with the staff member, Antonieta Gimeno, the LPAs observed, reviewed, and compared resident medication and electronic medication dispensing logs. First Aid Kit was present and contained all of the required components. LPA Pascua toured resident bedroom #2. Resident furniture was observed to be sufficient to meet their needs at this time. LPA Pascua toured resident bedroom #3. Resident furniture was observed to be sufficient to meet their needs at this time. Across from resident bedroom #3 LPA Pascua identified a linen closet. Linen was sufficient to meet the resident's needs at this time. LPA Pascua toured a shared resident bathroom. LPA Pascua also toured a bathroom connected to resident bedroom #1. Hot water temperature was measured to be 112 degrees. Grab bars were observed to be stable and in good repair at this time. Across the resident bathroom was a locked closet and LPA identified additional incontinence and cleaning supplies that are made inaccessible to the residents in care. LPA Pascua toured the garage. A washer and dryer to wash residents bedding and clothing was identified. Laundry detergent, bleach, and all other cleaning supplies were observed to be locked and made inaccessible to the residents 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. 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 s a result of this visit, the following deficiencies were observed and cited on the following LIC 809-D pursuant to Title 22 Rules and Regulations, Health and Safety Code. An exit interview was conducted. A copy of the 809, 809-C, 809-D, LIC421BG and appeal rights were printed and a copy was given to the facility. The licensee was informed that a failure to correct any deficiencies by plan of correction due date(s) may result in civil penalties.