Routine inspection·July 14, 2023

Licensing Program Analysts (LPA) Elsie Campos arrived at the facility unannounced to conduct a required annual visit at 9:45 a.m. The LPA was greeted by staff and met with Administrator Maria Tanglao and explained the reason for the visit. 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. KITCHEN: The LPA began the inspection in the kitchen/food service area at 10:15 a.m. the kitchen was observed to be clean and sanitary. Knives and cleaning supplies are stored inaccessible. Kitchen appliances were in operable condition. The facility had a sufficient supply of two-day perishable and seven-day nonperishable food. COMMOM AREAS : The facility is a single-story structure with a large sunroom, dining room and living room. The LPA did not observe any obstructions or hazards. At the time of the visit, living room, sunroom 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 of 74 degrees. Smoke detector(s) and carbon monoxide detector were tested and operational at the time of the visit. The LPA observed fire extinguishers throughout the facility which were last serviced 06/10/2022. Administrator stated the fire extinguishers are scheduled for service on 7/18/2023. OUTDOOR AREA: The backyard has outdoor area equipped with furniture for client use, a patio table with an umbrella. There is a side gate for client use and exit and is single latched. No bodies of water noted. The garage is where the washer and dryer are held, including emergency supply food items. Cleaning supplies and disinfectants are kept in in the garage. There was a linen cabinet in the garage with extra towels and linens. The garage is locked and inaccessible. Continued on LIC 809-C BEDROOMS: Bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There are five designated resident rooms. RESTROOMS: The 2.5 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 measured in bathrooms between 114.9-116.0 degrees Fahrenheit. RECORD REVIEW: At 12:40 p.m. a review of facility files was initiated. The LPA observed documentation of Disaster prevention, Insurance liability. Residents’ records review began at 12:40 p.m., 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 1:45 p.m.; medications are centrally stored and locked in a medication closet in the hallway; 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: Upon entry, the facility has a central entry point for symptom screening, temperature checks, and sanitation station. The facility has an adequate supply of Personal Protection Equipment (PPE) and the facility is able to obtain additional supplies as needed. The facility’s cleaning protocol is sufficient. If needed, the facility has the capacity to designate a single isolation room if the facility has a confirmed case of COVID-19. No deficiencies cited at this time. Exit interview conducted. A copy of the report was issued.