Routine inspection·September 26, 2024

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced to conduct a required annual visit today. Upon arrival, there were three (3) staff and four (4) residents present. LPA was greeted by facility staff who contacted the Administrator via telephone. The Administrator, Myline Olivas arrived at 9:57am. Entrance interview conducted. At 9:58am, 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 10:01am. 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. At 10:08am, the hot was temperature was checked in the kitchen sink and it measured 107.6 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. Activities for resident use were observed by the hallway. LPA observed auditory alarms at the time of the visit. There is a working telephone on premises. LPA observed fireplace adequately covered during the inspection. Report Continued on LIC 809C... Report Continued from LIC 809... Fire extinguisher was observed fully charged with a date of 8/09/2024. At 10:19am, 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. The hot water temperature was measured; the first bathroom measured at 107.6 degrees Fahrenheit at 10:10am; and the second bathroom measured at 106.8 degrees Fahrenheit at 10:14am. 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. Staff bedroom observed on premises. GARAGE: The garage is maintained inaccessible to residents in care. LPA observed an additional refrigerator and freezer 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 one (1) self-latching gate. 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 10:26am and Personnel Records at 11:22am. 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. Three (3) personnel files and the current 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. Although the facility has a designated training binder, the LPA was unable to determine the number of hours completed per regulation for the past 12 months. MEDICATIONS: Medications review began at approximately 12:45pm. Medications are stored in a locked cabinet adjacent to the kitchen inaccessible to residents in care. At 1:15pm, Resident #1’s (R1’s) centrally stored medication and destruction record (CSMDR) does not have PRN medication for Lorazepam 1mg tablet qty-30, date filled 08/12/2024, documented and has been started, as there are fifteen (15) tablets that have been administered. At 1:31pm, Resident #2's (R2's) CSMDR did not have medication Flecainide Acet tabs 50mg, date filled 07/26/2024 documented. Additionally, a separate bottle of Flecainide 50mg, date filled 08/28/2024 was documented on the CSMDR with a start date of 09/07/2024 was counted and had 49 pill remaining; however, there was no refusals documented which would indicate there would be 24 pills remaining. 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.