Routine inspection·January 4, 2024

At 09:15 a.m. Licensing Program Analyst (LPA) Esther Cortez arrived at the facility unannounced to conduct a required annual visit. The LPA was greeted by Administrator Ken Mahler and informed them of the reason for the visit. At 09:36 a.m. the LPA conducted a tour of the physical plant with Administrator Ken Mahler and Associate Administrator Gloria Morales to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was noted: Facility is a double-story residence that consists of one (1) memory care unit (MC), and an assisted living unit (AL). The memory care unit is secured with delayed egress doors which lead to secured outdoor patios. The LPA observed one of the delayed egress doors to be functional. The second floor has no resident apartments but was observed to have a gymnasium for resident use, facility storage, and office space. The LPA observed fire extinguishers throughout the facility, which were fully charged and last serviced 03/27/2023. Smoke alarms and carbon monoxide detectors were tested and functioned properly. The LPA observed all required postings outside the Administrators office. Kitchen : During the facility tour at 9:38 a.m., the kitchen appeared clean and the appliances and fixtures functional during the time of visit. The LPA observed a sufficient amount of perishable and non-perishable food at the facility. Food is prepared based on the menu. Snacks and beverages are available for residents. Bedrooms: During today’s visit, the LPA observed ten (10) randomly selected resident units, of which four (4) were in memory care and six (6) in assisted living. Nine out of the ten resident bedrooms were properly furnished with at least one chair, nightstand, and sufficient lighting for each resident. The bedrooms had appropriate and adequate bedding and linens such as sheets, pillowcases, mattress pads, and blankets. Report will continue on LIC809-C. Bedrooms continued: At 10:09 a.m. the LPA observed a bottle of over-the-counter 8HR Arthritis Pain Relief acetaminophen pills, a box of prescribed Aspercreme Lidocaine pain relief patches, a small tube of over the counter Maximum Strength Antibiotic Cream + pain relief, a tube of Biofreeze pain relieving gel, inside room# 195 in memory care. At 10:46 a.m. the LPA observed room 192 in memory care without a chair, and without a chest of drawers. Upon observation, the Associate Administrator stated rooms are furnished by the resident and/or their responsible party agreed on their admissions agreement. At 11:28 a.m. the LPA observed room 106 in AL to have a door that was not able to fully close, furthermore room #106 was observed to have prescribed and over the counter medication. Bathrooms: The LPA observed all ten bathrooms in the randomly selected rooms clean and sanitary with grab bars and non-skid mats. Water temperature measured in the restrooms ranged between 113.0 degrees Fahrenheit and 118.0 degrees Fahrenheit. Common Areas: These included the beauty salon, common areas and dining areas in assisted living and memory care. The common areas were checked for cleanliness and furniture was checked for functionality during time of visit. At 10:22 a.m. the LPA observed the laundry room in memory care unlocked with chemicals and cleaning supplies accessible to the residents. At 11:03 a.m. the LPA observed a laundry room in assisted living unlocked with chemicals and cleaning supplies accessible to the residents in care. The Administrator locked both l a undry rooms upon observation. The facility maintained a comfortable temperature of 69 degrees . There were no obstructions and/or tripping hazards throughout the facility. Surrounding Grounds (Outdoors) : The L PA observed appropriate outdoor furniture, with umbrellas available for shade in all of memory care & assisted living courtyards. There were no bodies of water on the premises. Interviews: During today’s visit, the LPA conducted five (5) resident and five (5) staff interviews. No concerns voiced during the interviews. Record Review: At 02:25 p.m. a review of facility files was initiated. The LPA reviewed four (4) of seventy-nine (79) resident files. Out of the four files reviewed, LPA Cortez identified that one out of four residents (R1) require an updated appraisal needs and service plan, due to the diagnosis of dementia. The LPA identified that one out of four residents (R2) did not have a personal rights form LIC 613 or medical consent forms on file. Administrator stated files are online and will sent to the LPA. Due to time constraints the LPA will return to complete the annual at a later date. Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D): Exit interview conducted and copy of the report and appeal rights provided.