Routine inspection·May 17, 2022

Licensing Program Analyst (LPAs) Mai Thao and Talwinder Bains arrived at the facility unannounced to conduct a Required-1 Year Inspection utilizing the infection control domain on today's date. LPAs met with Carol Pickard, Administrator and Jamie Scott, Nurse Manager. LPAs explained the purpose of the visit. Prior to initiating the annual inspection, LPAs completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPAs ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N95 In addition, Staff screened LPA prior to entering the facility. The current census for today is 18. Areas toured include but are not limited to: common area, resident bedroom, bathrooms, dining room, and activity room. In the areas toured no immediate health, safety, or personal rights violations were observed. LPAs and Licensee completed the infection control domain during this inspection. At approximately 3:12pm, LPAs, Nurse Manager and Staff 1 (S1) reviewed 5 of 5 resident Centrally Stored Medication (CSM). LPAs, Nurse Manager, and Staff observed these CSM not entered in the Centrally Stored Medication Logs: Resident 1 (R1) has 7 CSM, Resident 2 (R2) has 1 CSM, Resident 3 (R3) has 5 CSM, and Resident 4 (R4) has 2 CSM. Administrator stated that facility has been without a nurse for a while and has not conducted audit on CSM to ensure that they are entered in CSM logs accurately. At approximately 5:01pm, LPAs, Administrator, and Nurse Manager observed Resident 5 (R5) without a sign admission agreement on file. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22, and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted and appeal rights provided.