157209136-6-25-2024-24-AS-LPAT-D6KQ9W-20240625115902

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 157209136
Report Date: 05/31/2024
Date Signed: 06/25/2024 11:59:20 AM

Document Has Been Signed on 06/25/2024 11:59 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME:	REDWOOD SENIOR LIVING BAKERSFIELD		FACILITY NUMBER:	157209136
ADMINISTRATOR:	PONCE, BEATRIZ		FACILITY TYPE:	740
ADDRESS:	810 S UNION AVE		TELEPHONE:	(415) 810-0145
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93307
CAPACITY:	41	CENSUS: 39	DATE:	05/31/2024
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:37 AM
MET WITH:	Beatriz Ponce, Administrator		TIME COMPLETED:	01:38 PM

NARRATIVE

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Licensing Program Analyst L. Padgett arrived at the facility unannounced to conduct the Required Annual Inspection. LPA's met with Administrator Beatriz Ponce and Regional Director Steven Cruz. LPA explained the purpose of the inspection and was granted entry into the facility by the Med Tech.

A tour of the facility was conducted with the Administrator. The residence was set at 72 F temperature and free of passageway obstructions inside and outside.

Kitchen toured, supply of food observed and food stored properly for perishable and nonperishable. Medications were stored in a locked Medication room. Cleaning supplies were in a locked closet. Smoke detectors and carbon monoxide detectors were checked and operating. Tel-Tec Security Systems conducted a Fire Alarm system inspection on 5/7/2024. Facility has a fire sprinkler system. Fire extinguishers last inspected on 05/01/24, pressure gauge is in the good range.

Outdoors there are four patio tables with umbrellas and seating. LPA observed that the backyard is well maintained, trees and grass in good condition.

Resident, medication and staff records were reviewed. LPA reviewed staff and Resident files.

Due to time constraints deficiencies are listed below and citations will be issued at a later date. LPA will return to the facility at a later date.

An exit interview was conducted and a copy of this report was provided to Administrator.

SUPERVISOR'S NAME: Sergiy Pidgirny	TELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Lissett Padgett	TELEPHONE: (559) 243-8080
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/25/2024 11:59 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: REDWOOD SENIOR LIVING BAKERSFIELD	FACILITY NUMBER: 157209136
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/31/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Deficiency Dismissed

Type A

Section Cited

CCR

87608(a)(5)(B)

Postural Supports

(B) Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care and have a hospice care plan that specifies the need for full bed rails. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on LPA observation of three residents in hospital beds with full rail and the subsequent review of those resident files, only 1 had a hospice approval for the use of a full rail. Licensee did not comply with the section cited above for 2 of 3 residents which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 06/13/2024
	Plan of Correction
1 2 3 4	Licensee agrees to remove full bed rails and to have residents reassessed for the need of bed rails. If a resident is in need of a bed rail, the licensee will obtain a phsycian's order. Administrator provided this LPA with documation at the continuation visit for 1 of the residents and the full rail was removed from the remaining resident's bed.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Sergiy Pidgirny	TELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Lissett Padgett	TELEPHONE: (559) 243-8080
LICENSING EVALUATOR SIGNATURE:	DATE: 06/13/2024

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/25/2024 11:59 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: REDWOOD SENIOR LIVING BAKERSFIELD	FACILITY NUMBER: 157209136
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/31/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1569.625(b)(2)

Other Provisions

(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 3 of 4 staff files reviewed by this LPA which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/05/2024
	Plan of Correction
1 2 3 4	Licensee will have all annual training completed within 3 weeks of today's date. Going forward, training will be completed on a monthly basis.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Sergiy Pidgirny	TELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Lissett Padgett	TELEPHONE: (559) 243-8080
LICENSING EVALUATOR SIGNATURE:	DATE: 06/13/2024

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024

LIC809 (FAS) - (06/04)

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