Routine inspection·July 5, 2024

Licensing Program Analyst (LPA) Brian Balisi arrived at the facility unannounced to conduct a required annual visit. Upon arrival, the LPA met with staff and explained the reason for the visit. The Administrator, Donald Brodt arrived shortly after. The LPA 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. The LPA inspected the kitchen/food service area at approx. 9:00 a.m. The LPA observed one resident watching television. Knives are stored in a locked drawer to the left of the stove.  Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food properly stored at this time. At the time of the visit, the living room furniture was observed to be in good condition. The facility maintained a comfortable temperature of 72 degrees Fahrenheit. Smoke detector(s) and carbon monoxide detector were operational at the time of the visit. LPA observed fire extinguisher to be fully charged and purchased this year. The LPA observed four (4)  resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. The  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. The hot water temperature was measured in each restroom between 105 - 120 degrees Fahrenheit.  The staff area  was observed to be inaccessible to residents in care and empty during the time of the visit. Room #1 is not part of the facility and is rented out to a tenant who does not receive any care or supervision from staff. LPA observed room to be inaccessible to residents in care at this time. There is an Office area / employee lounge. LPA observed extra supply of non-perishable goods, medical supplies, emergency food, and other facility supplies.  All exits have functioning auditory devices and were operational at the time of the visit. The LPA observed required postings throughout the common space.  The backyard has a covered outdoor area equipped with furniture including a table and chairs for resident use. The LPA observed one (1) self-latching gate with clear passageways clear of obstruction. There were no bodies of water noted at the time of the visit. There is a storage shed located in the rear of the facility. LPA observed it to store extra facility and medical supplies at this time. Records review began at 10:00am. Five (5) resident records were reviewed for the following: signed admission agreements, current medical assessments with TB results, LIC627(c) Consent for Treatment form, appraisals, and current needs and services plan. All resident records were observed to be in order at this time. LPA reviewed staff files for, but not limited to, the following: personnel records, health screening, criminal record statements, and current first aid certification. At approx 11am, LPA observed Staff #1 (S1) to have criminal background clearance, but they were not associated to this facility. Administrator's file was not available to review at the time of the visit. Staff training records were not available to review at the time of the visit.  Last emergency disaster drill conducted last quarter. Administrator will conduct drill by end of month. Medications review began at 11:05 a.m. The medications are centrally stored and locked in a cabinet in the office area. Medications are labeled and checked for expiration dates. No errors found during medication audit. INFECTION CONTROL: Upon entry, the facility has a central entry point for symptom screening, temperature checks, and sanitation station. At this time, the staff will continue to keep up signs that promotes good hand hygiene and symptoms of a communicable disease. 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 an infectious disease. The facility’s policies and procedures as it pertains to infection control are adequate. Continued from 809-C LPA obtained the following documents at the time of visit: LIC500 Personnel Report, LIC9020 Client Roster, a copy of the emergency disaster plan, and a copy of the facility’s liability insurance. Interviews were conducted during the visit. Pursuant to Title 22 of the California Code of Regulations Division 6, Chapter 8, the following deficiencies were cited (refer to LIC 809-D). Civil Penalties assessed in the amount of $500. Failure to correct the deficiencies may result in additional civil penalties. Exit interview conducted. A copy of the report and appeal rights were provided