Facility Evaluation Report
On 3/19/2024 Licensing Program Analyst (LPA) K.Kaur arrived unannounced for an annual inspection visit. LPA was met by Administrator, Maria Ceballos. LPA introduced self, explained reason for visit and was permitted entry into the facility. Licensee Rachel Wolf arrived a short time later.
LPA toured the facility with the Administrator. All pathways, entrances and exits were clear from obstruction. LPA toured locked housekeeping room, and laundry room. LPA observed facility common areas were furnished with sufficient seating. The tour continued to the facility dining room and facility kitchen. The kitchen was observed clean, in good repair with necessary items and appliances. LPA observed a 7-day supply of non-perishable foods and 2-day supply of perishable foods.
Residents observed in common areas and in rooms. LPA toured several resident rooms which were observed to be furnished with required furniture and adequate lighting. At 11:49 AM LPA observed in Room # 22 window seal that was broken and decaying. Fire extinguishers observed throughout the facility with service date of 10/17/2023. Bathrooms were properly equipped with non-slip mats and grab bars. At 12:03 PM LPA observed broken tile in one of the bathrooms. The broken tile had black like appearance in the cracks. Black appearance was also visible along the grout lines. LPA observed dust and debris buildup on bathroom fan vent. At 12:14 PM LPA observed a staff office to be unlocked which contained disinfectants and cleaning supplies. Hot water temperature was tested between 105 degrees F and 120 degrees in several restrooms. Carbon monoxide detector tested and. LPA observed delayed egress doors. Facility observed with a signal system. LPA toured an enclosed patio area with sufficient seating and shade for recreational purposes. Cleaning supplies and chemicals are kept locked maintenance room. Resident's records contained signed Admission Agreement, Personal Rights, and current Physician's Report.
Deficiencies are being cited on the attached 809D in accordance with California Code of Regulations, Title 22,Division 6.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction