The LPA along with the Facility Designee and staff 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.

BEDROOMS/BATHROOMS: The LPA began the inspection with the downstairs bedrooms and bathrooms. Bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There are six designated client rooms. There was a linen closet in the upstairs hallway with extra towels and linens. The client bathrooms were clean and sanitary and in operating condition. The bathrooms were sufficiently stocked with soap and paper towels. The hot water temperature measured between 124.8 and 129.7 degrees Fahrenheit.

KITCHEN: The LPA inspected the kitchen/food service area. Knives and cleaning supplies are stored inaccessible. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Additional food supplies and emergency food supply is kept in the attached garage.

COMMON AREAS: At the time of the visit, living room and dining room furniture was observed to be in good condition. The facility maintained a comfortable temperature of 72 degrees. Smoke detector(s) and carbon monoxide detector were tested at 1:55 p.m. and operational at the time of the visit.

*Continued on LIC 9099-C**

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. A pool was observed to be covered and inaccessible, exits are free of obstructions.

RECORDS: Residents’ records review began at 12:30 p.m., records were reviewed for, but not limited to care plans, medical records, admissions agreement, consent forms. All records were in order.

Personnel records were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. Administrator did not have a valid administrator license on file. It was discussed that they would put in for renewal.

MEDICATIONS: Medications review began at 11:50 a.m., medications are centrally stored and locked in the Medication Room. The LPA audited four (4) resident files. The following is observed: medications are labeled and checked for expiration dates. For 2 out of 4 residents (Resident #1 and Resident #2), the facility did not have the prescription #’s recorded in the centrally stored medications log. In addition, staff assisted R2 with the self-administration of the medication Quetiapine and HydrOXYzine, yet it was not properly documented in the centrally stored medication log.

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 LPA obtained the following documents: LIC500 Personnel Report, Client Roster, Liability Insurance and Emergency and Disaster Plan. 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.