Routine inspection·September 5, 2023

On 9/5/2023, Licensing Program Analysts (LPAs) K. Kaur and K. Brown arrived unannounced at the above facility to conduct an Annual Inspection. LPAs introduced selves, stated the purpose of the visit and met with Executive Director Trina Sinift LPAs conducted facility tour with Administrator. All pathways, entrances and exits were clear from obstruction. LPAs toured locked office storage rooms, and laundry rooms. LPAs observed facility common areas which were furnished with sufficient seating. The tour continued to the facility dining room and facility kitchen. The kitchen was observed clean, in good repair with necessary items and appliances. LPA observed non-perishable and perishable foods. At 11:39 AM LPA observed the Ice Machine to have brown buildup underneath the door lift area. LPAs toured several resident rooms which were observed to be furnished with required furniture and adequate lighting. Fire extinguishers observed throughout the facility with service date of July 13, 2023. Bathrooms were properly equipped with non-slip mats and grab bars. Hot water temperature was tested between 105 degrees F and 120 degrees in several resident bathrooms. Carbon monoxide detector tested and operational in two hallways. Memory care toured with dining area/ Kitchen; several rooms toured. Residents observed with several care givers in commons areas playing music and exercising. LPA observed delayed egress doors. Facility observed with a signal system. LPA toured an enclosed patio area with sufficient seating and shade for recreational purposes. Cleaning supplies and chemicals are kept locked maintenance room. Resident's records contained signed Admission Agreement, Personal Rights, and current Physician's Report. Staff files were reviewed for good health. It was verified that there are at least two staff on duty who are CPR certified. Continued to next page... Facility files were reviewed for Resident council Meeting record, plan of operation with dementia care policy. Last fire drill conducted on 8/25/2023. At 4:23 PM LPA reviewed resident's medication, MARS, and Centrally Stored Medication and Destruction Record (CSMDR) and observed medication audit revealed for Resident 1 (R1) 2 dosages missed with no notes on MARS and Resident 2 (R2) one pill was missing. LPA also observed the CSMDR to be incomplete. Deficiencies are being cited on the attached 809D in accordance to California Code of Regulations, Title 22, Division 6. LPA is requesting the following documents be submitted to the Fresno CCL office by 9/19/2023: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Emergency and Disaster Plan, Personnel Report (LIC500), Register of Facility Clients/Residents LIC9020. An exit interview was conducted with Administrator. Report signed on-site; a copy of this report, 809D with appeal rights were provided.