KITCHEN: The LPA inspected the kitchen/food service area at 9:32 a.m. Kitchen appliances appeared clean and were in operable condition at the time of the visit. The facility has a sufficient supply of perishable and non-perishable food. Refrigerator and food pantry were checked for proper labels and expiration dates and food labels had expiration date clearly marked. Cleaning solutions, knives, and sharps were observed locked and inaccessible under the kitchen sink. At 9:38 a.m., the hot water temperature measured at 119.8 degrees Fahrenheit.

COMMON AREAS: At the time of the visit, living room and dining room furniture was observed to be in good condition. The facility maintained a comfortable temperature. Smoke detector(s) and carbon monoxide detector were operational at the time of the visit. The fire extinguisher was observed to be in compliance and last charged on 04/27/2023. The LPA observed required postings throughout the common space. There is a working telephone on premises.

(Report Continued on LIC 809C...)

GARAGE: The garage is attached to the facility. There is one (1) additional freezer with perishable items in good condition. The washer and dryer were observed inside the garage. The LPA observed detergents and cleaning supplies inaccessible to residents in care. There was emergency food and water in the garage which was observed to be in good condition. The LPA observed a sufficient supply of Personal Protection Equipment (PPE).

BACKYARD: The backyard has a covered outdoor area equipped with furniture for resident use. Emergency exits and passageways were observed free of obstruction. The property is gated. The facility has two (2) side gates that self-latch. No bodies of water noted at the time of the visit.

BEDROOMS: There are four (4) resident bedrooms. The LPA observed the resident bedrooms to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. There is a designated staff bedroom on premises.

RESTROOMS: There are two (2) resident restrooms. Restrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels; towels and washcloths are not shared. LPA observed proper hand washing signs inside the restrooms. The hot water temperature was measured in both bathrooms. First bathroom measured at 112.6 degrees Fahrenheit at 9:22 a.m.; and the second bathroom measured 119.3 degrees Fahrenheit at 9:31 a.m.

RECORDS: Records review began at 9:41 a.m.; four (4) resident records were reviewed for, but not limited to: appraisals/needs and service plan, medical records, admissions agreement, consent forms. All records were complete.

Two (2) personnel records were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were complete.

(Report Continued on LIC 809C...)

The facility is vendored by Tri-Counties Regional Center (TCRC) as a level 2-i home.

The last emergency disaster drill took place on 01/28/2024.

The LPA conducted one (1) staff interview at 8:50 a.m.

MEDICATIONS: Medications review began at approximately 11:15 a.m.; medications are centrally stored in a locked cabinet by the dining room. All medications including PRNs were labeled, stored, and locked inaccessible to residents. PRNs have physicians order on file. Medications are labeled and checked for expiration dates. Medications are properly documented on the centrally stored medications and destruction record. No errors observed during the medication review.

No deficiencies cited at this time. Exit interview conducted. A copy of the report was provided.