Routine inspection·July 23, 2024

Licensing Program Analyst (LPA) Zabel Chochian arrived at the facility to conduct a required annual visit. The LPA met with staff and reason for visit was stated. Assistant Administrator arrived shortly after. At approximately 11:15 a.m., the LPA, staff and Assistant Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that the facility is in compliance with Title 22 Regulations. COMMON AREAS : At the time of the visit, living room and dining room furniture was observed to be in good condition. There is a fireplace in the living room, which is screened and inaccessible. The facility maintained a comfortable temperature of 74 degrees. Smoke detector(s) and carbon monoxide detector were tested and operational at the time of the visit. The LPA observed fire extinguishers throughout the facility which were last serviced 04/15/2024. LPA observed required postings throughout the common space. There is a laundry room where cleaning supplies and disinfectants are kept locked in cabinets. The garage (converted into office space) is attached to the home and therefore kept locked/inaccessible to others. Emergency food supplies, water and Personal Protection Equipment is stored in the garage/office space. BEDROOMS: Bedrooms observed furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There are five (5) designated resident bedrooms and two (2) staff rooms. RESTROOMS: There are five (5) resident restrooms. Restrooms observed clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with soap and paper towels. The hot water temperature in bathrooms measured between 115-117 degrees Fahrenheit. KITCHEN: The kitchen was observed to be clean and sanitary. Knives and cleaning supplies are stored inaccessible. Kitchen appliances were in operable condition. The facility had a sufficient supply of two-day perishable and seven-day nonperishable food. OUTDOOR AREA: The backyard has a covered outdoor area equipped with furniture for client use. There is a side gate for client use and is single latched. No bodies of water noted and exits are free of obstructions. RECORD REVIEW: Residents’ records review began at 12p.m., records were reviewed for, but not limited to care plans, medical records, admissions agreement, consent forms. All records were in order. At approximately 12;45p.m., Staff 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. MEDICATIONS: Medications review began at 1:30p.m.; medications are centrally stored and locked in a mediation 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. The LPA requested following documents to be faxed to the Regional Office: - LIC500 Personnel Report - Liability Insurance No deficiencies cited at this time. Exit interview conducted. A copy of the report provided.