Routine inspection·September 19, 2024

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced to conduct a required annual visit today. Upon arrival, there were two (2) staff and four (4) residents present. LPA was greeted by facility staff who contacted the Administrator via telephone. The Administrator, Laila Kulunga arrived at 8:42am. Entrance interview conducted. At 8:45am, the LPA along with the Administrator 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. The following was observed: KITCHEN: The LPA inspected the kitchen/food service area at 8:51am. Knives and sharps were observed in a locked drawer inaccessible to residents in care. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food; properly stored. Refrigerator and food pantry were checked for proper labels and expiration dates; labels had dates clearly marked. At 8:54am, the hot was temperature was checked in the kitchen sink and it measured 123 degrees Fahrenheit. COMMON AREAS: This includes the living room and dining room area. The common areas were furnished appropriately and appeared to be in good condition at the time of the visit. The facility maintained a comfortable temperature. LPA observed required postings throughout the common space. LPA observed a hallway closet with resident’s personal hygiene items locked at the time of the visit. Activities were observed in the living room. LPA observed auditory alarms at the time of the visit. Report Continued on LIC 809... Report Continued from LIC 809C... There is a working telephone on premises. LPA observed fireplace not adequately covered during the inspection. Staff ordered fireplace cover during the inspection. Fire extinguisher was observed with a date of 8/28/2023. Staff purchased new fire extinguisher during the inspection. At 9:06am, the smoke detectors and carbon monoxide detector were tested and operational at the time of the visit. Emergency disaster drills conducted quarterly as per regulation; the last drill was conducted on 08/1/2024. RESTROOMS: The two (2) resident restrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels. Hand washing signs were observed posted inside the bathrooms. The hot water temperature was measured; the first bathroom measured at 122.1 degrees Fahrenheit at 9:03am; and the second bathroom measured at 126.1 degrees Fahrenheit at 9:05am. Staff adjusted the water temperature during the inspection. BEDROOMS: There are four (4) bedrooms for resident use; two (2) bedrooms are designated as single occupancy; and two (2) bedrooms are designated as double occupancy. All resident rooms were observed to be furnished appropriately and had sufficient lighting. Additional clean linens, towels, and washcloths were observed in the hallway closet. GARAGE: The garage is maintained inaccessible to residents in care. LPA observed an additional refrigerator with food in good condition. There is a washer and dryer inside the garage. Cleaning supplies, detergents, and toxins were observed in a locked cabinet inaccessible to residents in care. Facility has an adequate amount of emergency food and water. LPA observed a sufficient supply of Personal Protection Equipment (PPE). BACKYARD: The backyard has a covered patio area with adequate furniture for resident use. The exterior passageways were clean and clear of any obstructions at the time of the visit. LPA observed two (2) self-latching gates. There were no bodies of water noted at the time of the visit. Report Continued on LIC 809C... Report Continued from LIC 809C... RECORDS: LPA reviewed Resident Records at 9:32am and Personnel Records at 10:13am. Four (4) resident files were reviewed for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, LIC627(c) Consent for Treatment form, and current needs and services plan. All files were complete. Two (2) personnel files including the Administrator’s file were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid / CPR training, and the appropriate training. At 10:21am, record review revealed Staff #1 (S1) was hired on August 2024; however, staff file indicated S1 completed training the month prior to being hired. The Administrator certificate is valid until 01/24/2025. During today's inspection, the LPA conducted two (2) staff interviews. MEDICATIONS: Medications review began at approximately 11:30am. The medications are locked in cabinet in the kitchen. At 11:56am, Resident #1’s (R1’s) Centrally Stored Medication and Destruction Record (CSMDR) indicated R1 is being applied Arnicare cream daily on bruises with a start date of 08/01/2024; however, the facility did not have doctor’s orders / prescription on file. Staff obtained copy of doctor’s order / prescription during the inspection. 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.