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25 | At approximately 8:55AM, Licensing Program Analyst (LPA) Felias arrived unannounced to continue a 1-Year Required Visit and met with Staff Member, Sandra Lopez. Administrator, Rufus Zingkhai arrived during visit at approximately 9:30AM. Facility serves residents with dementia and has a plan of operation for dementia care and programming on file. Facility has an approved fire clearance and total capacity for 28 non-ambulatory residents and has an approved hospice waiver for 6 individuals. Upon arrival, LPA was informed that there were 16 Residents in care and 4 staff members on-site.
At approximately 9:05AM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. At approximately 9:15AM, LPA reviewed staff files, resident files and resident medication. All files were all found to be well organized, thorough and contained the required documentation. Staff files had current First Aid and CPR certification. Medication was observed to be centrally stored and secure. Administrator's Certificate for Rufus Zingkhai (7033932740) was current with an expiration date of 08/15/2025.
LPA requested the following documents to update facility file:
- Designation of Facility Responsibility (LIC 308)
- Emergency Disaster Plan (LIC 610D)
- Updated Personnel Report (LIC 500)
- Register of Clients/Residents (LIC 9020)
- Updated Liability Insurance
- Active and Current Administrator Certificate
Documents to be submitted to Community Care Licensing (CCL) by due date of 11/11/2024.
No Deficiencies Cited during Visit.
Exit interview conducted. Copy of report discussed and provided to Administrator. Signature on form confirms receipt of documents. |