Routine inspection (multi-day)·August 28, 2023

Licensing Program Analyst (LPA) Elsie Campos arrived at the facility unannounced to conduct a continuation to a required annual visit at 12:45 p.m. The LPA was greeted by staff and informed them of the reason for the visit. Administrator Paul Oyasan arrived shortly thereafter. MEDICATIONS: Medications review began at 1:00 p.m.; medications are centrally stored and locked in a filing cabinet in the dining room. 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. RECORDS: Residents’ records review began at 2:25 p.m., records were reviewed for, but not limited to care plans, medical records, admissions agreement, consent forms. The following was noted: 4 resident records (S1, S2, S3 , S4) were incomplete. 4 out of 4 resident records (S1,S2, S3, S4) were missing the consent to medical treatment form at the time of record review. S2, S3 and S4 were missing the needs and form and S2 was missing the pre-appraisal form. Administrator was reminded that files need to be completed in a timely manner upon residents admission to the facility. 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.