Routine inspection·February 20, 2024

Licensing Program Analyst (LPA) Zabel Chochian arrived at the facility unannounced to conduct a required annual visit. Upon arrival LPA met with staff (2). Staff contacted back-up administrator Karina Antig, who arrived shortly after LPA. Reason for the visit was stated. At approximately 11:45am, the LPA and administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. Smoke and carbon monoxide detectors tested and functioned properly during today's visit. KITCHEN: Knives and cleaning supplies are stored in a locked cabinet. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Medications were stored in a locked cabinet . The door to the garage, which is in the kitchen observed locked during today's visit. BEDROOMS: The LPA observed six single-occupancy client bedrooms which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting; and one staff room. RESTROOMS: Restrooms observed to be clean, sanitary and in operating condition; stocked with paper towels, toilet paper and soap. Restrooms observed with grab bars installed and shower mats. The facility had an adequate supply of Personal Protection Equipment (PPE) and the facility is able to obtain additional supplies as needed. COMMON SPACES: The living room, family room and dining room furniture were observed to be in good condition. The backyard patio is equipped with furniture for resident use. Resident files reviewed for completeness and accuracy at approximately 12:30pm. Five (5) out of six (6) resident files did not have an updated Needs and Services Plan. Staff files reviewed at approximately 3pm Staff 1 and 2 did not have record of TB clearance; Initial required training for staff was not met; staff lacked medication shadowing and dementia care training hours. Resident Medication records reviewed at approximately 4pm - Medication records and procedures reviewed and observed to complete and accurate. Pursuant to Title 22 CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D). Exit interview conducted. Copy of report and appeal rights provided.