Routine inspection·September 16, 2024

Licensing Program Analysts (LPAs) Angela Barutyan and Kelly Dulek arrived at the facility unannounced to conduct a required annual visit at 09:57AM. LPAs met with staff and Wellness Manager (WM) Mehrnoush “Mimi” Ghorbankhani. Entrance interview conducted. Beginning at 10:20AM, the LPAs, along with the WM toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed: LPAs observed fire extinguishers on every floor which were fully charged and last serviced 09/12/2024. Fire alarm devices are tested annually and were last tested 07/08/2024. Delayed egress door in the memory care unit was tested at 11:28AM and was functional at the time of the visit. COMMON SPACES/AMENITIES: Common areas include the dining area, theater, gym, salon, physical therapy room, the Bistro, game room, arts and crafts room, a small outdoor courtyard, and a Wellness Center. Several common living spaces were observed throughout the facility. There is a functioning telephone on the premises. The emergency exiting plans/sketch are posted in the hallways. The emergency telephone numbers are posted in the entryway. Other required postings are posted on the first floor near the elevator. LPAs observed the Ombudsman Poster and DSS Complaint Poster throughout the community. LPAs observed pull cords readily available in the resident's restrooms and observed residents to be wearing signal pendants. BEDROOMS: LPAs observed a random selection of nine (9) bedrooms at the facility of which two (2) were on the first floor, three (3) were on the second floor, and three (3) were in the memory care unit. All bedrooms were furnished appropriately with clean linens, furnishings, and sufficient lighting. Continued on LIC 809-C RESTROOMS: LPAs observed resident restrooms to be equipped with grab bars near the toilet and shower/tub, non- skid surfaces in the shower/tub, and pull cords. LPAs tested water temperatures in resident bathrooms and were measured to be between 105.4 and 110.7 degrees Fahrenheit, which is within the required range. KITCHEN: At 11:30AM, LPAs toured the kitchen in the memory care unit. At 11:32AM, LPAs observed the cabinet under the sink to be unlocked and containing cleaning chemicals and solutions as well as the drawer next to the sink to be unlocked and containing a pair of scissors. WM Ghorbankhani and Maintenance Director Michael Cornejo locked the kitchen area during the time of the visit. LPAs toured the main kitchen at 12:30PM. Kitchen appliances were in operable condition. The facility has a sufficient supply of two (2) days perishable and seven (7) days non-perishable food as well as an emergency food and water supply. MEDICATION REVIEW: At 10:53AM, LPAs reviewed medications for two (2) residents in the memory care unit and at 11:42AM, LPAs reviewed medications for two (2) residents in the assisted living unit. All medications reviewed were stored and documented per regulation. RECORD REVIEW: Beginning at 01:09PM, LPAs reviewed six (6) staff and five (5) residents files for documents including but not limited to: resident Admission Agreement, TB test, health screening, staff training and fingerprint clearance. Six (6) out of 6 (six) staff files observed were missing 40 hours initial and 20 hours annual training and three (3) out of six (6) staff files were missing First Aid training. All five (5) resident files reviewed were in compliance with regulation at the time of the visit. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today's visit, LPAs reviewed the facility's infection control policy as well as the emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Emergency disaster plan is updated annually as required. Emergency disaster drills are conducted quarterly as is required, with the last drill conducted on 09/12/2024. INTERVIEWS: During today’s visit, LPAs interviewed five (5) residents and four (4) staff. During today's visit, LPAs obtained a copy of the facility's liability insurance. Pursuant to Title 22, CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D). Civil penalties were issued in the amount of $1000. Administrator was informed that failure to correct deficiencies may result in additional civil penalties. Exit interview conducted, report issued, and appeal rights provided.