The facility is a Residential Care Facility for Elderly (RCFE) with a license capacity of (6), and a current census of (6). LPA conducted a general inspection of facility, which included, but was not limited to, the following:

Operation/Physical Plant: Indoor and outdoor passageways were kept free of obstruction. The facility has no swimming pools or similar bodies of water. The facility's outdoor activity space is shaded and protected by self-latching gates. The facility is maintained at a temperature of 74 degrees fahrenheit(F). Resident bedrooms were furnished with beds, night stands, chairs, bed linen and bedroom lighting. Resident bathroom fixtures were operating properly. The hot water temperatures in the bathrooms measured at 105 degrees (F). The facility is equipped with fully charged fire extinguisher, smoke/carbon monoxide alarms, night lights, door signal system, emergency supplies/water, laundry equipment, and telephone service. The facility has posted in a common area: Ombudsman poster, facility license, evacuation plan and emergency telephone numbers. Sharps and cleaning supplies were kept locked and inaccessible to residents in care. An emergency&disaster plan, infection control plan, and liability insurance is maintained at the facility.

Food Service: The facility's kitchen area was maintained cleaned. A 7-day supply of non-perishable and a 2-day supply of perishable foods was maintained at the facility. The facility maintains a sample menu for review.

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

• Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

• Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

Record Review: Four (4) resident files were reviewed for admissions agreements, physician’s reports, preplacement appraisals, needs and services plans. Review of a resident files reveals, there was no documentation of a current hospice care plan maintained for Resident#4 (R4). Four (4) staff files were reviewed for First Aid/CPR certifications, criminal record clearances, job training, and health screenings. Review of staff files reveals, staff#1(S1) who administers medication to residents did not have annual medication training on file. Staff#2 (S2) did not have documentation of an annual dementia, postural support, hospice training on file.

Based on LPA observations and records reviewed, deficiencies were cited per Title 22, Division 6, of the California Code of Regulations and Health & Safety Codes.

An exit interview was conducted where this report was discussed and a copy with appeal rights was provided to the Administrator at the conclusion of the visit.