Health inspection·April 6, 2022

Title 22 Article 6 Physical Plant, Section 72601(a) 72601. Alterations to Existing Buildings or New Construction. (a) Alterations to existing buildings licensed as skilled nursing facilities or new construction shall be in conformance with Chapter I, Division 17. Part 6. Title 24, California Administrative Code [Reference: 2019 California Building Code Section 1225.2 - New buildings and additions, alterations, or repairs to existing buildings subject to licensure shall comply with applicable provisions of the California Electrical Code, California Mechanical Code, California Plumbing Code and California Fire Code (Parts 3,4, 5 and 9 of Title 24)] and requirements of the State Fire Marshal. On 2/18/2022, the California Department of Public Health (CDPH) made an unannounced visit to the facility to investigate a complaint related to physical environment. The facility failed to obtain required written authorization, building permit, and attain construction approval from the Department of Health Care Access and Information (HCAI, the State Agency that reviews and approves plans for construction, repairs, renovations, and remodeling made to healthcare facilities to comply with State Building Codes) for the installation/replacement of three water heater and the construction of a shed that housed the water heaters. On 2/24/22, at 12:30 pm, during an interview, the Administrator stated they were going to install two more air handler units within the next three weeks. The Administrator stated she was unaware of any specific details regarding the history of the construction/alterations at the facility. On 2/18/2022, at 10:45 a.m., during an interview with the Administrator, in the presence of the Maintenance Supervisor (MS), the Administrator stated a few years ago, the facility had replaced the water heaters and now had a total of three water heaters. All the water heaters were in the same room and were replaced at different times. The first two water heaters were replaced within the same year. MS stated, first "we replaced water heater #3 and then we replaced water heater # 1 and then, water heater #2." The Administrator explained he was not working at the facility when first two water heaters were replaced. The Administrator stated, "if something breaks down, we call our vendor who works with our consultant to fix the issue. They go through everything and obtain the necessary approvals." On 2/18/2022, at 11:45 a.m., during a facility tour with the Administrator and MS, the following was observed: - Three 100-gallon water heaters inside a shed in the patio area. MS stated, "all the water heaters were insulated per OSHPD/HCAI inspector's instructions, and the contractor called the gas company to insulate all the water heaters." - A shed which housed the three water heaters. MS stated he was working at the facility since 11/2011 and the shed was already there. On 2/18/2022, at 12:54 p.m., during a concurrent interview and record review, the Administrator provided a HCAI/OSHPD approval document (Project # S150033-19-00ACD0001) for the emergency replacement of the water heaters. HCAI/OSHPD approved the project on 7/11/2019. The Administrator was not able to locate/provide any further documentation that the installed/replaced water heaters received final construction sign-off approval from HCAI/OSHPD. On 2/18/2022, at 1:30 p.m., during further review of the details for Project # 150033-19-00-ACD0001, on the HCAI/OSHPD website, the project information identified that on 2/6/2015, "the shed housing the water heaters was noted as unauthorized construction and installed without required permit, review, or approval from OSHPD ..." On 2/18/2022, at 2 p.m., during an interview, the Administrator stated he was not able to locate and provide documentation the shed was approved by HCAI/OSHPD. The facility failed to obtain required written authorization, building permit, and attain construction approval from HCAI for the installation/replacement of three water heater and the construction of a shed that housed the water heaters. The above violation had a direct relationship to the health, safety, and security of all residents.