1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25 | Licensing Program Analyst (LPA) Cuadra conducted an unannounced Annual Required – 1 yr. and met with Licensee Emma Mutunga. There were 4 residents present at the facility. Required postings observed.
LPA/staff toured the facility around 12:45pm. The facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguishers were found to be last charged on 12/4/23, smoke detectors & carbon monoxide detectors were found to be operational during the visit. Last disaster drill was conducted on 8/5/24. Hot water temperature; it measured 112.1 and 110.9 degrees F which is within acceptable regulations of 105 to 120 degrees F in 2 out of 2 resident’s bathroom faucets. There was a supply of cleaners, hygiene products and paper products available for residents. All resident’s bedrooms have lighting & appropriate furnishings. Toxins are stored in a cabinet in the garage that was locked at time of inspection. Medication is centrally stored and locked in a closet located in the kitchen. The facility has one week of perishable food and two days of nonperishable food observed stored and handled as stated per regulation.
At approximate 1:00pm LPA initiated a review of three staff and four resident files. One out of four residents care plan was not updated (technical violation issued); all resident's files are current with their medical assessments. All staff files have active CPR/first aid certificates and required training hours. Administrator Certificate for Emma Mutunga, 6003067740, expires 4/18/2025. At approximate 2:00pm LPA/Licensee conducted spot check of medications and found resident's (R1) medications were two out of twenty medication were expired as follow: Advair Diskus 250/50mg inhale 1 puff into the lungs twice daily (expired as of November 2024) and Dulcolax 10mg (PRN expired June 2024). Licensee discarded expired medication.
LPA provided updates of the following forms: LIC500 - Personnel Report, LIC308 Designated Administrative Responsibility, copy of control of property and Certificate of Liability Insurance.
Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview was conducted with Licensee and a copy of this report was provided. |