Routine inspection·October 8, 2024

On 10/08/2024, Licensing Program Analyst (LPA) K. Kaur arrived unannounced at the above facility to conduct a Annual Inspection. LPA introduced self, stated the purpose of the visit, and was granted entry to the facility by staff. LPA met with Administrator Esmeralda Coronado LPA conducted facility tour with Administrator. All pathways, entrances and exits were clear from obstruction. LPA observed facility common areas which were furnished with sufficient seating. The tour continued to the facility dining room and facility kitchen. At 11:14 AM LPA observed unlocked medication pills without a label, Eye drops and Hydrogen Peroxide in a cabinet in the dining area. The kitchen was observed clean, in good repair with necessary items and appliances. LPA observed 7-day nonperishable and 2-day perishable foods. At 11:18 AM LPA observed the Ice Machine to have Black mold underneath the door lift area and observed the inside of the lid was cracked. LPA 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 October 3, 2024. Bathrooms were properly equipped with non-slip mats and grab bars. Residents observed in dining room playing Bingo. Carbon monoxide detector tested and operational in hallways. Memory care dining area toured. 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. 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. Staff files were reviewed for good health. It was verified that current staff on duty is CPR certified. At 1:05 PM LPA observed 3 residents with dementia diagnosis had medical assessment that were a year old. Continued to 809-C During Medication Audit LPA observed R’s medication was not logged in Centrally Stored Medication and Destruction Record (CSMDR). During Pill count it was observed pill bottle had extra 8 pills, Staff informed LPA medication was transferred from one bottle to the other so that is why the count is off. Deficiencies are being cited on the attached 809D in accordance with California Code of Regulations, Title 22, Division 6. LPA is requesting the following documents be submitted to the Fresno CCL office by 10/15/2024: 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. Civil Penalty assessed for repeat violation. Report signed on-site; a copy of this report, 809D with appeal rights were provided.