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25 | Licensing Program Analyst (LPA) Victoria Brown arrived unannounced to conduct a Required - 1 Year visit on 7/6/23 at 9:00am. Administrator Certificate expired 3/12/23, however, pertinent documents observed to be submitted to Community Care Licensing. License fees are current.
LPA met with Hyacinth Durloo, Caregiver and discussed the purpose of the visit. The administrator Javanika Zaveri arrived within 15 minutes to assist with todays visit. The facility is licensed for a capacity of 6 non-ambulatory residents. LPA observed 2-day perishables and 7-day non-perishables. Hospice waiver approved for 2 residents of which there is 1 resident receiving hospice services at this time.
The temperature inside the facility was observed to be at 73*F which is within the required range of 68-85*F. The hot water temperature was measured at 105.7*F which is within the required range of 105-120*F. LPA observed a pull alarm system, fire extinguisher(s), smoke and carbon monoxide detectors, and central heating and air in the facility. LPA observed the centrally stored medications area to be locked and inaccessible to residents. The first aid kit contained the required items such as sterile dressings, bandages, adhesive tape, scissors, tweezers, thermometers, antiseptic solution and guide. LPA reviewed 2 resident and 2 staff files and conducted interviews during this visit.
Upon a file review the following items were discussed to be submitted with any changes annually:
Designation of Facility Responsibility (LIC308)
Liability Insurance
Personnel Report (LIC500)
Administrator Certificate-Updated
Per the California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies observed or cited. Exit interview held, copy of report given |