Routine inspection·July 23, 2024

Licensing Program Analysts (LPAs) Angela Barutyan and Trevor Byrne arrived at the facility unannounced to conduct a required annual visit at 10:09AM. LPAs met with Health Services Director (HSD) Aleesha Zuniga, and Administrator Jeanphilippe Rollet. Entrance interview conducted. At 10:41AM, LPAs began file review while Administrator finished up a tour of the facility. At 01:12PM, the LPAs conducted a tour of the physical plant with Administrator Rollet 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 2 (two) memory care units named Creekside and Oceanside respectively, and an assisted living (AL) unit. The LPAs observed fire extinguishers throughout the facility, which were fully charged and last serviced 06/05/2024. The Administrator provided an annual fire alarm testing and inspection report done on 04/04/2024 where all smoke alarms and carbon monoxide detectors were tested and functioned properly. At 1:22PM, LPAs tested 1 (one) delayed egress door in the Creekside unit and was observed to be functional. The LPAs observed all required postings in the hallway near the entrance area. The facility serves residents with dementia, and the auditory alarms on the exit doors were tested and functioned properly at the time of visit. KITCHEN : At 1:25PM, LPAs toured the kitchen. Kitchen was observed to be clean. Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of 7 (seven) days non-perishable and 2 (two) days perishable food. LPAs observed dietary restrictions and accommodations for residents posted throughout the kitchen. Food is prepared based on the menu. Snacks and beverages are available for residents at the bistro. Report Continued on LIC 809-C BEDROOMS: During today’s visit, the LPAs observed 10 (ten) resident rooms of which 3 (three) were in the Creekside unit, 3 (three) were in the Oceanside unit, and 4 (four) were in the AL unit. The 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. BATHROOMS: The LPAs observed 10 (ten) resident bathrooms which were properly supplied and had functional fixtures at the time of the visit. The LPAs observed grab bars by the toilet/shower and non-skid surfaces in all bathrooms. Between 1:20PM and 2:32PM, water temperatures in all 10 (ten) bathrooms were measured between 107.5 and 116.7 degrees Fahrenheit, which is within the required range. COMMON AREAS: These included the beauty salon, library, bistro and dining areas in assisted living and memory care units. The common areas were checked for cleanliness and furniture was checked for functionality during time of visit. The facility maintained a comfortable temperature of 71 degrees. There were no obstructions and/or tripping hazards throughout the facility. GROUNDS/OUTDOORS : The LPAs observed appropriate outdoor furniture, with covered shaded areas for residents in both memory care units’ courtyards and the assisted living courtyard. Parking is available for residents and visitors. The LPAs observed a water fountain with an appropriate amount of water that does not pose a risk for residents. INFECTION CONTROL: The community's policies and procedures pertaining to infection control are adequate. RECORD REVIEW: LPAs began record review at 10:41AM. Staff and resident records were reviewed for documents including, but not limited to: health screening, TB test, staff training records, fingerprint clearance, resident physician's report, needs and service appraisal, and personal rights. LPA Byrne reviewed 5 (five) of 79 (seventy-nine) resident files and were observed to contain all required documents. LPA Barutyan reviewed 5 (five) staff files and were observed to contain all required documents. Report Continued on LIC 809-C MEDICATION REVIEW: Medications for 5 (five) residents were observed. All medications observed were labeled, stored, and properly documented at the time of the visit. INTERVIEWS: During today’s visit, the LPAs conducted 5 (five) resident interviews and five (5) staff interviews. No concerns voiced during the interviews. During today's visit, LPAs obtained a copy of the facility's liability insurance. Pursuant to Title 22 of the CA Code of Regulations, the following deficiency was cited (refer to LIC 809-D): Civil penalty was issued in the amount of $500. Administrator was informed that failure to correct deficiencies may result in additional civil penalties. Exit interview conducted and copy of the report and appeal rights provided.