Routine inspection·September 26, 2023

At 09:00 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 Bernardito Suarez and informed them of the reason for the visit. At 09:20 a.m. the LPA conducted a tour of the physical plant with Administrator Suarez 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 single-story residence that consists of six (6) resident bedrooms, two (2) staff bedrooms and four (4) bathrooms. The LPA observed fire extinguishers throughout the facility, which were fully charged and last serviced 06/12/2023. All smoke alarms and carbon monoxide detectors were tested and functioned properly. The LPA observed all required postings in the hallway near the entrance area. The facility serves residents with dementia, the auditory alarms on the exit doors were tested and functioned properly at the time of visit. Kitchen : During the facility tour at 9:22 a.m. the kitchen appeared clean and the appliances and fixtures functional. The LPA observed a sufficient amount of perishable and non-perishable food at the facility; Sharp objects are stored in a locked drawer to the right of the stove and cleaning supplies are stored in a locked cabinet. Bedrooms: 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 LPA observed all bathrooms, properly supplied and had functional fixtures. The LPA observed grab bars and non-skid mats in all bathrooms. The hot water was measured in the master bedroom #1 bathroom during physical plant tour. Hot water measured 107.0 degrees Fahrenheit, within the required limit of 105-120 degrees Fahrenheit. Report will continue on LIC809-C. Common Areas: These included the living room and dining area. The common areas were checked for cleanliness and furniture was checked for functionality during time of visit. The facility maintained a comfortable temperature of 73 degrees. There were no obstructions and/or tripping hazards throughout the facility. Surrounding Grounds (Outdoors) and Garage: The LPA observed appropriate outdoor furniture, with a covered shaded area for residents. There were no large bodies of water on the premises. The garage is locked and attached to the house Infection Control: The home has an adequate supply of Personal Protection Equipment (PPE) and can obtain additional supplies. The community's cleaning protocol is sufficient. The community's policies and procedures pertaining to infection control were adequate. Record Review: At 10:00 a.m. a review of facility files was initiated. The LPA reviewed five (5) of five (5) Resident Files. Out of the five files reviewed, LPA Cortez identified that two out of five residents (R1, R2) require an updated physician’s report, and three out of five residents require an updated appraisal/needs and services plan due to the diagnosis of dementia. Otherwise, all resident records were in order. The LPA reviewed five (5) out of five (5) staff files. All staff files appeared complete and current. The LPA observed documentation of Infection Control and Disaster prevention. Administrator stated quarterly disaster drills have not been conducted. The LPA obtained Client Roster and Staff Roster. Medications: At 11:15 a.m. a medications review was initiated. Medications are centrally stored and locked in a cabinet in the kitchen; medications are labeled and checked for expiration dates. Medications are properly documented on the centrally stored medications and destruction record. No errors observed during the medication review. I nterviews: At 11:40 a.m. the LPA conducted two (2) client, and two (2) staff Interviews. No immediate concerns voiced during the visit. 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 to Administrator Bernardito Suarez