KITCHEN: The LPA inspected the kitchen/food service area at 9:05 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. Food labels were inspected and checked for dates and expiration dates and food labels had expiration date clearly marked. Cleaning supplies, knives, and sharps were observed locked and inaccessible to residents in care.

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. The fire extinguisher was observed to be in compliance and last charged on 01/08/2024. The LPA observed a closet in the hallway with extra towels and linens. The LPA observed required postings throughout the common space. There is a working telephone on premises. Auditory alarms were observed properly working at the time of the visit. LPA observed a fireplace to be adequately screened.

(Report Continued on LIC 809C...)

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

BEDROOMS: There are four (4) resident bedrooms. Three (3) bedrooms are single occupancy, and one (1) bedroom is double occupancy. The LPA observed the resident bedrooms to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting.

RESTROOMS: There are three (3) resident restrooms. Two (2) restrooms are located in the hallway and the third restroom is located in bedroom #1. 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. The hot water temperature was measured in all bathrooms; the first bathroom measured 130.8 degrees Fahrenheit at 8:58 a.m.; the second bathroom measured 127.2 degrees Fahrenheit at 9:01 a.m.; and the third bathroom measured 136.2 degrees Fahrenheit at 9:03 a.m. The Administrator had water temperature adjusted at the time of the visit.

RECORDS: Records review began at 9:37 a.m.; three (3) resident records were reviewed for, but not limited to: appraisals, medical records, admissions agreement, consent forms. All resident files were complete.

(Report Continued on LIC 809C...)

The LPA conducted a resident interview at 8:43 a.m.

MEDICATIONS: Medications review began at approximately 10:50 a.m.; medications are centrally stored in a locked cabinet in the dining room. Medications are labeled and checked for expiration dates. Medications are properly documented on the centrally stored medications and destruction record.

During the visit, the Administrator reported to LPA that they plan to change ownership in the future. LPA advised the Administrator to notify all residents and their representatives thirty (30) days prior their intent to sell the business.

The following deficiencies were observed (See LIC 809-D) and cited from the California Code of Regulations, Title 22 and/or California Health and Safety Code. Failure to correct the deficiencies may result in additional civil penalties.

Exit interview conducted. A copy of the report and appeal rights were provided.