Routine inspection·July 12, 2024

Licensing Program Analyst (LPA) Zabel Chochian conducted a Required annual inspection visit. The LPA met with staff and assistant Administrator Marina Karina Antig. At approximately 12pm., the LPA and Ms. Antig 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 : Kitchen knives are stored locked and inaccessible in the kitchen cabinet under the sink. The supply of perishable and nonperishable food is adequate. The supply of dishes is adequate. Appliances in the kitchen were clean and appeared functional. There is a sufficient supply of emergency food and water. Ms. Antig was advised to separate the emergency food supply from their daily supply use. BEDROOMS : There are (7) seven bedrooms in the facility; the facility licensed with four (4) private bedrooms for resident use, (1) shared bedroom for resident use and (1) one staff room. During todays visit LPA observed an additional resident bedroom. Ms. Antig explained that they added a dry wall in the living room. main This room and created an additional bedroom after licensure. All resident rooms have direct access to the outside except for the newly added room. Lighting in the rooms appeared adequate; rooms were set up with all required furniture. BATHROOMS : There are (2) two full bathrooms and (1) one half bath for resident use; the half bathroom near the entrance of the main hallway at the entrance of the home is designated for and guests. The bathroom located in the hallway observed ceiling in needed of patching and paint; also the base board in this bathroom also need to be repaired/painted (rusted/in disrepair). Staff have a private staff bathroom located next to the Staff room. COMMON AREA: The common areas were appropriately furnished, and the lighting was adequate. There is a television and other entertainment equipment in the living room area. The facility smoke alarm system is hard wired; the smoke detectors were operable at the time of the visit. Fire extinguisher observed fully charged and last serviced in 05/2024. There is a functioning telephone on the premises. Emergency exiting plans/sketch are posted. Emergency telephone numbers are posted in hallway bulletin board.Other required postings are also posted in the main hallway bulletin board. LAUNDRY : The laundry area is behind the kitchen area, directly across from the designated staff room. Laundry detergent and chemicals are stored inaccessible in a large cabinet to the right of the washer and dryer. Surrounding Grounds (Outdoors) : The LPA observed appropriate outdoor furniture, with a covered shaded area for residents. There are no bodies of water on the premises. Record Review: At approximately 2pm, a review of the staff files was conducted. Staff lack complete medication training and shadowing by skilled medical professional; Required 40 hour training was not complete for (2) staff present during todays visit. Record Review: At 3pm. a review of facility resident files was initiated. The LPA reviewed six (6) out of six (6) resident files. The following was observed: Two out six residents did not have a pre-placement appraisal (LIC 603), or appraisal/needs and services plan (LIC625). Per assistant administrator resident 2 and 3 are identified as bedridden. Per the fire clearance, the facility does not have a bedridden fire clearance at this time; also failed to notify LPA and obtain fire clearance for newly added resident bedroom. An immediate civil penalty of $500 is assessed, due to a violation of the fire clearance. MEDICATIONS reviewed at approximately 4:30pm: Medications are in a locked cabinet in the kitchen to the left upon entry from the main home entrance. The first aid supplies were complete, including a first aid manual. They were stored in the medication cabinet. Centrally stored medication records for residents is not maintained accordingly (missing start dates); PRN authorization not on file for resident #3. 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.