LPA conducted a general inspection of facility, which included, but was not limited to, the following:

Operation/Physical Plant: The facility is operating in the capacity approved by Community Care Licensing Division (CCLD). The facility has no swimming pools or similar bodies of water. The facility has sufficient indoor and outdoor space for resident activities. LPA observed a sufficient supply of books, puzzles, games for resident activities. Resident bedrooms were furnished with beds, night stands, chairs, bed linen, sufficient lighting and maintained at 74 degrees F. Resident bathrooms were maintained clean and fixtures were fully operating. The hot water temperature in room#7, wing 2, measured 135.5 degrees F. Deficiency cited. The facility is equipped with operating fire and carbon monoxide alarms, laundry equipment, and telephone service. The facility has posted in a common area Community Care Licensing complaint poster, Ombudsman poster, facility license, weekly menus, activities, and emergency telephone numbers. LPA observed in room #1, wing 2, next to resident's bed an insecticide spray and disinfectant wipes. LPA observed in room #1, wing 1, disinfectant wipes next to resident's bed. Deficiency cited. LPA observed in wing 2, laundry detergent left out in opened laundry area with no staff present. Deficiency cited. LPA observed in room #1, wing 1 a scratched and damaged wall next to resident's bed and window. The exit door in the memory care was not opening. The Administrator stated that the door sticks shut and will have the door repaired. The exterior exit door in the memory care wing was not closing properly. The Administrator stated that a lock is currently placed temporarily unit the door is repaired. Deficiency cited.

Care & Supervision: The facility staff schedule reflects 24 hours a day, 7 days a week staff coverage.

Health Related Services: Resident medications are kept in a locked medication cart and in a locked medication room. LPA observed, resident #1 (R1) prescribed noon medication for 11/19/24 was not given as medication was still in the bubble pack, no documentation as to why the medication was not given to resident. At 11:29 am, LPA observed resident #2 (R2) evening medication for 11/20/24 was missing from the bubble pack and a slit in the back of the medication was observed. Staff stated that sometimes the pharmacy do not place the medication in the pack. LPA observed resident #3 (R3) injector pen medication was not label. Staff stated that the label should have been on the cap. No cap was found.

Record Review: Six (6) resident files were reviewed. LPA observed resident #R4 (R4), resident #5 (R5), resident # 6 (R6) had no preplacement appraisals on file. Six (6) staff files were reviewed. LPA observed staff #1 (S2), Staff #2 (S2), Staff #3 (S3) did not have first aid/CPR training on file for review. The Administrator’s certification, facility’s insurance, emergency disaster plan and infection control plan is up-to-date.

Based on LPA observations and records reviewed, deficiencies were cited and technical advisories were issued per Title 22, Division 6, of the California Code of Regulations.

An exit interview was conducted where reports (LIC809/ LIC809-C/LIC809-D/ LIC9102) were discussed and copies were provided with appeal rights to the Administrator at the conclusion of the visit.