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25 | Licensing Program Analyst (LPA) Ruth Wallace conducted an unannounced 1 Year Required Annual Inspection Visit. LPA met with Administrator and explained the purpose of the visit. Administrator Certificate #6049221735 expires on 08/19/2022. LPA was later me by Licensee who conducted tour with LPA.
This facility is a single story building licensed to serve four (4) ambulatory & 2 non-ambulatory residents. LPA and Licensee toured the physical plant including but not limited to two resident bedrooms, two resident bathrooms, garage and backyard area. LPA observed the facility to be free of odor, clean and in good repair. LPA observed sufficient furniture and lighting throughout the facility. There are no bodies of water present.
LPA observed sufficient seven day non-perishable and two day perishable food supplies. Hot water temperature was measured at (113.0) degrees Fahrenheit in resident bathroom sink, which is within the required regulation of 105 to 120 degrees Fahrenheit. Fire extinguishers and smoke and carbon monoxide detectors are in compliance with fire safety. Fire extinguishers expire 05/26/2023 and smoke detectors are current and in compliance with fire safety. LPA noted the facility had the required carbon monoxide detectors. First aid kit was checked and is complete. LPA observed centrally stored medications secure from residents and toxins/sharp knives kept locked and inaccessible to clients.
LPA reviewed staff associations to the facility. LPA reviewed 5 resident records and (3) staff records. LPA reviewed medications for 2 residents comparing with Centrally Stored Medication Record and physician orders. LPA observed that the facility is dispensing medications as prescribed. A review of (3) staff records indicates that all facility staff has received criminal record clearances and/or are associated to this facility. Staff records reviewed indicated current first aid certificates and training completed.
LPA requested the following forms to be updated and submitted to CCLD by 06/30/22:
LIC 308 LIC 309, LIC 400, LIC 402, LIC 500
LIC 610-D, Copy of Administrator Certificate, Copy of Surety Bond, and Control of Property
Per California Code of Regulations, Title 22 Division 6, Chapter 8, no deficiencies were found during today's visit. Exit interview held with Licensee and a copy of report given at the conclusion of the visit. |