Routine inspection·June 5, 2024

Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced to conduct a required annual visit. Upon arrival, LPA met with Operations Manager Angelica Arambulo. Entrance interview conducted. At 01:27PM, the LPA, along with facility 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. The following was observed: RECORD REVIEW: LPA reviewed staff and resident files for documents including, but not limited to: physician's report, Admission Agreements, personal rights, staff fingerprint background clearance, TB test results and health screenings. 1 (one) staff (Staff #1 - S1) did not have proof of fingerprint background clearance, but has been working for the facility since April 2024. Additional items observed will be addressed during the annual continuation visit. RESIDENT ROOMS/RESTROOMS: Resident rooms are either single or double occupancy. 10 (ten) resident rooms were observed during today's visit and contained the appropriate furnishings, linens, and bedding. Resident restrooms are jack-and-jill style - shared between 2 adjacent rooms. Restrooms observed were clean and sanitary in operating condition. Water temperature was tested in a sample of resident restrooms and measured at 86.4 degrees Fahrenheit in one resident restroom. Other remaining resident water temperatures were within the required range. COMMON AREAS: Laundry room door lock and staff room door lock were observed to both be broken at the time of the visit. Laundry detergent was observed to be accessible in the laundry room and staff belongings, which included visible medications, among other personal belongings were also accessible to residents in care. Report Continued on LIC 809-C BUILDINGS AND GROUNDS: During facility tour, LPA noted that all exterior gates are padlocked and/or chained and locked. Facility staff stated that the cameras were being repaired and in the meantime, gates were locked for resident safety. Operations Manager stated that if the gates are locked, this should be approved in the fire clearance. Review of facility plan of operation and fire clearance documents are unclear whether locked perimeter is approved. Further investigation is needed to determine if a violation occurred. LPA will address this during the annual continuation visit. Due to time constraints, LPA will return at a later date to continue the annual inspection. The following deficiencies were observed (See LIC 809-D) and cited from the California Code of Regulations, Title 22 and California Health and Safety Code. A $500 civil penalty was assessed. Failure to correct the deficiencies may result in additional civil penalties. Exit interview conducted. A copy of today's report and appeal rights were provided.