Routine inspection·November 27, 2023

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced for a required one-year annual inspection today at 9:00 a.m. The last annual conducted at this facility was on 12/16/2022. When the LPA arrived, there were two (2) staff and four (4) residents present. The LPA was greeted at the door by staff Wilfredo Ladio. The Administrator arrived at the facility at 9:35 a.m. and the reason for the visit was explained. Entrance interview conducted. At 9:40 a.m., the LPA along with the Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. KITCHEN: The LPA inspected the kitchen/food service area at 9:51 a.m. Kitchen appliances appeared clean and were in operable condition at the time of the visit. The facility has a sufficient supply of perishable and non-perishable food. Food labels were inspected and checked for dates and expiration dates and food labels had expiration date clearly marked. The knives and sharps are stored in a locked drawer inaccessible to residents in care. At 9:52 a.m., the water temperature was tested in the kitchen faucet, and it measured 112.1 degrees Fahrenheit. COMMON AREAS: At the time of the visit, living room and dining room furniture was observed to be in good condition. The LPA observed one resident watching television in the dining room during the inspection. The facility maintained a comfortable temperature. At 10:01 a.m., the smoke detector(s) and carbon monoxide detector were tested and operational at the time of the visit. The fire extinguisher was observed and fully charged on 09/11/2023. Different activities are offered to residents daily. The LPA observed reading books and puzzles accessible to residents in care. The LPA observed a closet in the hallway with extra towels and linens. (Report Continued on LIC 809C...) (Report Continued from LIC 809...) A separate closet was observed with at least a 30-day supply of Personal Protection Equipment (PPE). The LPA observed required postings throughout the common space. GARAGE/BACKYARD: The garage is kept locked at all times. The washer and dryer were observed in the garage. Detergents and cleaning solutions were observed in a locked cabinet. The facility has emergency food and water which was observed to be in good condition. The backyard has a covered outdoor area equipped with furniture for resident use. Emergency exits and passageways were observed free of obstruction. There were two (2) gates with self-latching mechanisms. No bodies of water were noted at the time of the visit. BEDROOMS: There are four (4) resident bedrooms. Bedrooms #1 and #4 are shared bedrooms. The LPA observed the resident bedrooms to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. There is a staff room on premises. RESTROOMS: There are three (3) resident restrooms. Restrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels; towels and washcloths are not shared. The hot water temperature was measured in all bathrooms; the first bathroom measured 114.6 degrees Fahrenheit at 9:43 a.m.; and the second bathroom measured 114.8 degrees Fahrenheit at 9:47 a.m.; and the third bathroom measured 113.7 degrees Fahrenheit at 9:49 a.m. RECORDS: Records review began at 10:06 a.m.; four (4) resident records were reviewed for, but not limited to: appraisals, medical records, admissions agreement, consent forms. At 10:15 a.m., record review of Resident #1’s (R1’s) Physician’s Report (LIC 602A) indicates R1 has no capacity for self-care; however, can feed themselves occasionally. Records indicate R1 was discharged from hospice and Licensee stated they will have R1 re-evaluated to indicate R1 has capacity for self-care. (Report Continued on LIC 809C...) (Report Continued from LIC 809C...) Four (4) personnel records were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were complete. The LPA also audited the current Administrator’s file, and it was in order. The last earthquake drill took place on 10/23/2023. At the time of the visit, the LPA obtained the following documents: LIC 500 Personnel Report, LIC9020 Client Roster, and a copy of the liability insurance. MEDICATIONS: Medications review began at approximately 12:15 p.m.; medications are centrally stored and locked in a cabinet inside the kitchen. All medications including PRNs were labeled, stored, and locked inaccessible to residents. PRNs have physicians order on file. Medications are labeled and checked for expiration dates. Medications are properly documented on the centrally stored medications and destruction record. No errors observed during medications review. Exit interview conducted. No deficiencies cited. A copy of the report was issued.