Routine inspection·July 10, 2024

On 7/10/2024, Licensing Program Analyst (LPA) K. Kaur arrived unannounced at the above facility to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was granted entry to the facility by Administrator Jacklyn Becerra. Administrator Deborah Salazar arrived shortly after. LPA conducted facility tour with Administrator Jacklyn Becerr. All pathways, entrances and exits were clear from obstructions. The tour started in kitchen, continued to dining room, living room and resident rooms. LPA observed a 7-day supply of non-perishable foods and a 2-day supply of perishable foods. Sharps are locked in kitchen cabinet. Facility Laundry room is connected to Kitchen. Laundry room observed locked with cleaning supplies and chemicals. Office area observed with back up supplies and cleaning supplies; Office is kept locked when no one present. Dining room and Living room observed with sufficient seating and activities for residents. Facility has three resident at this time. LPA toured several bedrooms which were observed to be furnished with required furniture and adequate lighting. Bathrooms were properly equipped with non-slip mats and grab bars. Fire extinguisher in hallway was last serviced on 7/2/2024 and was fully charged. Carbon monoxide and smoke alarm detectors installed and operational. Linen supply is kept in the hallway closet. Medications are kept in locked cabinets in the hallway. Last fire drill conducted on 5/17/2024. Resident's records contained signed Admission Agreement, Personal Rights, and current Physician's Report. Medication Audit conducted. Staff files were reviewed for good health. 2 out of 3 staff were not associated with the facility. It was verified that current staff on duty is CPR certified. LPA observed sufficient seating under covered patio area in the back of the facility. Side gate was self-closing and self-latching. Deficiency is being cited on the attached 809D in accordance with California Code of Regulations, Title 22, Division 6. Immediate Civil Penalty assessed for caregiver background check. Continued to LIC809C LPA is requesting the following documents be submitted to the Fresno CCL office by 7/17/2024: 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. Report signed on-site; a copy of this report was provided with appeal rights.