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25 | Licensing Program Analyst (LPA) Talwinder Bains arrived on 09/03/24 to conduct the annual inspection. LPA met with Staff, Iwan Wibowo (S1) and explained the purpose of today's visit. Staff and LPA spoke with Administrator, Hardosubroto Alfonsus via phone who gave permission S1 to assist LPA with today's visit since Administrator was not available.
During today's annual inspection, the Compliance and Regulatory Enforcement Tool was used.
LPA reviewed two (2) residents and two (2) staff files and found all required documents.
LPA and S1 toured the facility together to ensure the health and safety of residents in care. The areas toured included resident rooms, bathrooms, kitchen, and common areas and outside area. The food supply is within compliance, 2 days of perishable and 7 days worth of non-perishable food items. Grab bars were present at the toilet and in the shower. All exits were unobstructed. There is a side gate for emergency access. LPA checked the kitchen area for the ability to prepare and store food. Knives and Sharp objects found to be locked. LPA observed the area used for medication to be locked and inaccessible to residents. LPA observed smoke detectors and carbon monoxide detector at the care home are operational. Fire extinguisher was last serviced on 06/13/24 and was ready for emergency use. Hot water temperature was observed to be 120 degrees F, which is within the regulation range of 105-120 degree. Inside temperature was 74 degree F. Facility was clean and well organized. All required postings were observed. Facility is conducting quarterly fire and disaster drill as required.
LPA requested a copy of the LIC 500, LIC610E and current liability insurance to be sent to the Department by 09/30/24.
No deficiencies were observed or cited per Title 22, CCR Regulations during this visit.
Exit interview conducted and copy of this report was provided . |