Routine inspection·September 13, 2023

Licensing Program Analyst (LPA) Elsie Campos arrived at the facility unannounced to conduct a required annual visit at 10:20 a.m. The LPA was greeted by staff and explained the reason for the visit. Administrator Elmira Sabyrova arrived shortly thereafter. At 10:45 a.m. the LPA and 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. Kitchen: The LPA inspected the kitchen and food area at 10:45 a.m. Knives and sharps were observed in a locked drawer next to the stove. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Refrigerator and food pantry were checked for proper labels and expiration dates. At 10:49 a.m. the LPA discovered the following expired items in the refrigerator, expired cabbage, bell pepper, milk expired 9/2/23 and 9/3/2023, Parmesan cheese expired 12/30/2022, pickles expired 4/2/2023, cheese expired 9/6/2023, cream cheese expired 4/16/2023 and 6/4/2023. Staff disposed of all expired items at the time of the visit. The LPA also discovered unlocked refrigerated medications. LPA advised Administrator that refrigerated medications need to be kept in a lock box. Common areas: Living and dining room furniture were observed to be in good condition. At 12:00 p.m., smoke detector(s) and carbon monoxide detector were tested and were operational at the time of the visit. The LPA observed required postings throughout the common space. The fire extinguisher was observed and last purchased on 12/27/2021. Administrator advised they would replace the fire extinguisher immediately. The laundry room is located in the main hallway and is locked and inaccessible. The garage is attached to the facility and is locked and inaccessible. The facility has a sufficient amount of emergency water and food supplies. (Report Continued on LIC 809C...) (Report Continued from LIC 809...) Outdoor: There are 3 sheds in backyard that are used for storage. The backyard has a covered outdoor area equipped with furniture for client use. The LPA observed two side gates that are self-closing and latched. Passageways were observed clear of obstructions in case of an emergency. No bodies of water noted at the time of visit. Restrooms: The client restrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with soap and paper towels. At 11:11 a.m. the LPA observed unlocked cleaning supplies, powdered bleach and disinfecting wipes. The hot water temperature was measured in all bathrooms; water measured at 122.5 to 128.6 degrees Fahrenheit between 11:33 a.m. and 11: 42 a.m. The administrator adjusted the water temperature at the time of the visit. Water temperature read 120 degrees Fahrenheit at 3:22 p.m. Bedrooms: There are five (5) private resident bedrooms, which were furnished with appropriate linens and required furniture. Adequate lighting in all bedrooms was observed. There is one (1) staff room which was locked. At 11:17 a.m. the LPA observed unlocked cough syrup in bedroom # 4. RECORD REVIEW: Residents’ records review began at 12:45 p.m., records were reviewed for, but not limited to care plans, medical records, admissions agreement, consent forms. All records were in order. Personnel records were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were in order. (Report Continued on LIC 809C...) (Report Continued from LIC 809C...) MEDICATIONS: Medications review began at 1:45 p.m.; medications are centrally stored and locked in a mediation 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. INFECTION CONTROL: Upon entry, the facility has a central entry point for symptom screening, temperature checks, and sanitation station. The facility has an adequate supply of Personal Protection Equipment (PPE) and the facility is able to obtain additional supplies as needed. The facility’s cleaning protocol is sufficient. If needed, the facility has the capacity to designate a single isolation room if the facility has a confirmed case of COVID-19. 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. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted. A copy of the report and appeal rights were provided.