Routine inspection·March 22, 2024

Licensing Program Analyst (LPA) Zabel Chochian arrived at the facility unannounced to conduct a required annual visit. LPA met with staff and reason for visit was explained. Licensee Maria Mendez was contacted. The LPA and staff toured the physical plant areas inside and outside at approximately 11am to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. BEDROOMS: The LPA observed four (4) single-occupancy and one (1) double-occupancy resident bedrooms. Four of the bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. The one (1) double-occupancy resident room was observed vacant during todays visit. RESTROOMS: Three restrooms observed clean and sanitary; fixtures in operating condition. Hot water temperature tested (114'F) and observed to be within required range (105-120'F). COMMON SPACES: At the time of the visit, living room and dining room furniture was observed to be in good condition. KITCHEN: Knives were stored in a locked drawer and cleaning supplies were stored in the locked cabinet under the sink and garage. Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Carbon monoxide and smoke alarms were tested and all functioned properly. The fire extinguisher appeared fully charged and observed last inspected on 07/14/2023. Resident files were reviewed at approximately 11:30am for updated Needs and Services plans, medical assessments, admission agreements, and all other pertinent documents in their files. R3's hospice records were not complete - updated care plan service, and no written proof of training provided by Hospice on file. A technical violation was issued at this time. Staff records were reviewed at approximately 12:30pm and noted to be complete for first aid certification, health screening documentation, training requirements, employee rights and criminal record clearance. All staff and resident files were observed to be complete at this time. Medications are kept in locked cabinets in the office area. LPA reviewed medications and physician’s orders with Mrs. Mendez at approximately 1:30pm for all three residents and found they are being given as prescribed. Technical violation was issued for prescription label altered (R2). Exit interview held. Copy report provided.