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25 | Licensing Program Analyst (LPA) Ruth Wallace conducted an unannounced 1 Year Annual inspection visit. LPA was greeted by S1 Adelaida Deguzman and informed her of the purpose of the visit. Administrator arrived at facility at 3:00 PM. Facility is licensed for 6 beds with a fire clearance for 3 ambulatory, 3 non-ambulatory, 2 hospice, and 1 bedridden residents. Current census is 4. There are no residents on hospice or receiving bedridden care at this time. Three residents are under the Assisted Living Waiver Program. Administrator Certificate is current and expires on 2/5/23.
LPA toured the facility and physical plant with S1. Dining table, kitchen, three shared resident rooms, two full common bathrooms, and garage. The garage is off-limits to the residents and is used for storage, laundry cleaning, and office. The backyard was inspected. There is a double-gate on the same side as the garage. LPA toured the facility and reviewed the Mitigation Plan as well as discussing Personnel Policies, Abuse Reporting Procedures, In-Service Training and Medication Procedures. Smoke alarms and carbon monoxide detectors were tested and were operable. LPA toured resident rooms which contained all appropriate furnishings and accommodations. LPA also inspected the living room and family room areas. 7 days of non-perishable, and 2 days of perishable food items are in place. Fire extinguisher was charged and expires 11/4/2022. Sharp objects and toxins were inaccessible to residents in care.
LPA reviewed 2 staff charts and all records were present, including required training. All staff are fingerprint cleared and associated to work in the facility at this time. 4 resident charts were reviewed. All necessary components were present and updated including admission agreement.
Medications were locked and secured. Hot water temperature measured at 110.3 F degrees in kitchen area. First aid kit was accessible and stocked appropriately.
LPA observed the following posted in the facility: See Something Say Something complaint poster, Reporting Requirements per AB40, Resident Bill of rights, Resident Personal Rights, Evacuation Routes and facility license were all posted as required.
The following deficiencies were cited per Title 22 Division 6 Chapter 8 of the California Code of Regulation. Appeal Rights were given to the Administrator.
Exit interview was conducted with Administrator and a copy of reports and appeal rights were given at the conclusion of the visit. |