Routine inspection·July 27, 2023

Licensing Program Analyst (LPA) Zabel Chochian arrived at the facility unannounced to conduct a required annual visit. Upon arrival LPA observed two staff on duty. Reason for visit was stated. Staff contacted Administrator Maria Mendez. The LPA and staff 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. Administrator arrived shortly and continued the physical plant tour with LPA. BEDROOMS: Resident bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There are four resident rooms, two which are shared and two private rooms. There is one staff room, which is kept locked. There was a linen closet in the hallway with extra towels and linens RESTROOMS: The two resident 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. COMMON AREAS: Living room and dining furniture was observed to be in good condition. There is a fireplace in the living room, which is covered and inaccessible. The facility maintained a comfortable temperature. Smoke detector(s) and carbon monoxide detector were operational at the time of the visit. The fire extinguishers were charged and were last serviced 7/12/2023. Exits have functioning auditory devices and were operational at the time of the visit. The LPA observed required postings throughout the common space. KITCHEN: Knives are stored in a locked drawer, appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. The backyard has a covered outdoor area equipped with furniture for resident use. There is a side gate for resident usage and is single latched. There were no bodies of water noted. The washer and dryer are held in the garage, including additional nonperishable and perishable food items. Cleaning supplies and disinfectants are kept in locked cabinets in the garage. (continue to LIC809c) RECORDS: Personnel records reviews began at 11:45a.m. and were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. The following was noted: According to Health and Safety Code 1569.625, required training topics not meet for three out of three staff files reviewed. Discussion held with Administrator Maria Mendez at great length regarding required training topics and better organization of training records to account for required training for staff during annual visit. Resident records review began at 1:30pm; resident records were reviewed for, but not limited to: appraisals, medical records, admissions agreement, consent forms, and hospice records. All resident records accounted for after a great length of research done by Licensee/Administrator (for hospice care plans and full rail orders). MEDICATIONS: Medications review began at 3p.m.; medications are centrally stored and locked in a cabinet in the living room; medications are labeled and checked for expiration dates. Medications are properly documented on the centrally stored medications record. However a PRN authorization letter was not on file for resident #1 and the log for the cough syrup PRN medications was not completed. The following deficiencies were observed (See LIC 809-D.) and cited from the California Code of Regulations, Title 22 and California Health and Safety Code. Exit interview conducted. A copy of the report and appeal rights provided.