Routine inspection·September 16, 2024

Licensing Program Analyst (LPA) Esther Cortez conducted an unannounced required annual visit to the above facility. LPA met with the Administrator Maria Ayala and explained the reason for the visit. Medication Audit: At 3:20 p.m. a medication audit for three (3) residents was initiated. The following was observed: The medications were stored in a locked kitchen cabinet which is locked and inaccessible to the residents in care; medications are labeled and checked for expiration dates. Medications are properly documented on the centrally stored medications and destruction record. During Resident #1 (R#1's) audit, the LPA observed the following over the counter medications without a prescription, D-Mannose with Cranberry & Hibiscus 1,300 mg. Upon observation the Administrator stated that R1's family member had brought that medication. R1's family member was contacted and confirmed they had brought that medication in error in place of the prescribed Cranberry extract 500mg, and was able to bring the correct medication during the visit. At 03:51 p,m. the LPA toured the physical plant areas inside and outside with the administrator to ensure there are no health and safety hazards. LPA tested the smoke alarms and carbon monoxide detector which functioned properly. The fire extinguisher was recently purchased in August of 2024. KITCHEN: Kitchen knives are stored in a locked cabinet in the kitchen along with the medications. The supply of dishes, utensils, pots, pans and drink ware is adequate.. The supply of perishable and nonperishable food is adequate. There are no toxins in any food storage area or preparation area with utensils. Appliances in the kitchen were clean and all appeared functional. Kitchen, laundry and house cleaning supplies are stored in the locked garage. No flies or other vermin were observed. The garage was observed locked and contained the emergency food supply, and a laundry area that contained laundry supplies. Report will continue on LIC809-C. (2ND PAGE). Bedrooms: There are two (2) shared rooms and two (2) single rooms. All resident rooms had appropriate furnishings, clean linens, and adequate lighting. Restrooms: There are three (3) total bathrooms at the home. One (1) is designated as a staff bathroom, one (1) is in the common hallway, (1) restroom is in a shared bedroom for resident use. The resident bathrooms have a shower with non-skid materials. The toilet and showers have grab bars. Hot water temperature was measured at 113.5*F in both resident bathrooms. Common Spaces: In the common areas, walls and flooring were checked for cleanliness and good condition. At the time of the visit, common seating area and dining room furniture was observed to be in good condition. LPA observed the required postings in the common hallway. The backyard has a covered outdoor area equipped with furniture for resident use. There were no bodies of water noted. Record Review: At 4:28 p.m. a review of facility files was initiated. The LPA reviewed five (5) out of six (6) resident files. The following was observed: One resident (R2) did not have their required updated Physician medical assessment (LIC602) due to their Dementia diagnosis. Upon observation the administrator stated that they had taken R2 to get their physical already however, the Physicians office did not want to release the form until the TB results were out. The administrator called R2's physician office and they confirmed that the physical was done and awaiting TB results and stated they would be sending it soon. The LPA advised the Administrator to review R3’s file, as their LIC602 indicated that R3 was bedridden, however the LPA observed R3 able to move and walk. The LPA reviewed four (4) out of seven (7) staff files. Al files were complete and current. Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D): Exit inter view conducted and copy of the report and appeal rights provided to Administrator Maria Ayala.