Routine inspection·October 23, 2024

Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced to conduct a required annual visit at 10:20AM. The LPA was greeted by staff and informed them of the reason for the visit. Administrator Marisol Flamenco arrived shortly thereafter. Entrance interview conducted. Beginning at 10:40AM, the LPA and 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. The following was observed: Fire extinguisher was observed to be fully charged and Administrator stated was recently purchased, around the time of LPA Chochian's last visit. LPA Dulek advised Administrator to retain proof of purchase date. All combination smoke and carbon monoxide detectors were functional during testing. KITCHEN/GARAGE : The LPA began the inspection in the kitchen/food service area. One knife and one lighter were observed in a small drawer next to the stove, which was unlocked and accessible to residents in care. Items were secured in a locked location upon discovery. Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Adjacent to the kitchen is the facility garage. The garage was observed to be locked and contains emergency food and water, extra food, cleaning supplies, and laundry. COMMON AREAS : At the time of the visit, living room and dining room furniture was observed to be in good condition. There is a fireplace in the living room, which is screened and inaccessible. The facility maintained a comfortable temperature throughout the visit. Auditory alarms on exit doors were observed to be functioning at this time. The LPA observed required postings throughout the common space. BEDROOMS: Bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There are 5 (five) designated resident rooms; 4 (four) are private rooms and 1 (one) is a Report Continued on LIC 809-C shared resident room. There was a linen closet in the hallway with extra towels and linens. RESTROOMS : The facility contains 3 (three) restrooms. 1 (one) full restroom and 1 (one) half bath are located in the hallway and are designated for shared use. 1 (one) restroom is located in a private resident room, however is utilized by another resident, as it contains an accessible shower and the common restroom does not. Resident restrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with soap and paper towels. The hot water temperature initially measured low, however was retested later when the washing machine cycle had completed and measured at 107.4 degrees Fahrenheit. RECORDS: Records review began at 11:04AM; records were reviewed for, but not limited to: care plans, medical records, admissions agreement, consent forms. All records were in order. Personnel records were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were in order. MEDICATIONS : Medications review began at 01:19PM; LPA reviewed medications for 2 (two) residents. Medications are centrally stored and locked in a medication cart in the kitchen; medications are labeled and checked for expiration dates. Medications are properly documented on the centrally stored medications and destruction record. No errors observed during the medication review. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: The facility has an infection control plan and emergency disaster plan; both of which were observed to be complete and updated annually as required. Emergency disaster drills are conducted quarterly, with the last drill documented on 08/13/2024. INTERVIEWS: During today's visit, LPA conducted interviews with both staff and residents. No concerns were noted during interviews. The following deficiencies were observed (See LIC 809-D) and cited from the California Code of Regulations, Title 22 and/or California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted. A copy of the report and appeal rights were provided.