Facility Evaluation Report, 09/28/2023 — Mountain View Cottages -II, Diamond Bar CA

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced Annual Required 1-year Visit on 09/28/2023 at 10:27 am. LPA was met by Staff #1 (S1) and explained the purpose of the visit. Facility is licensed to serve four (4) residents ages 60 and above, of which three (3) may be non-ambulatory and one (1) bedridden. The facility provides dementia care for residents and serves developmentally disabled residents. All residents receive services from San Gabriel Valley/Pomona Regional Center.

LPA OBSERVATIONS: Tour began at 10:32 am and was led by S1. The facility is a single-story building located in a residential neighborhood with three (3) resident bedrooms, four (4) staff bedrooms, three (3) bathrooms, kitchen, dining room, living room, front yard, backyard, and attached garage.

Front Yard: Was clean and well maintained. No hazards were observed. Front door screen is torn/ripped near the handle.

Kitchen: LPA Ramirez observed sufficient 2 days of perishables and 7-day supply on non-perishables. LPA Ramirez observed knives and sharps located in kitchen cabinet, to be inaccessible to three (3) out of three (3) residents in care. LPA Ramirez observed several bottles of cleaning solutions and disinfectants located in kitchen cabinet, to be inaccessible to three (3) out of three (3) residents in care. Kitchen sink water temperature was measured at 112.8 degrees F. Kitchen appliances were observed to be clean and in working order.

Dining Room/Living room/: Dining room was observed to be clean and contained one table with plenty of seating. Living room was observed to have plenty of seating and lighting. LPA Ramirez observed several missing curtain blinds from living room window. LPA Ramirez will issue Type B deficiency. LPA Ramirez observed fully charged fire extinguisher in this area. LPA Ramirez observed one (1) out of three (3) residents, attending day program via zoom, in living room during visit.

Linen Closet: Contained plenty linens, towels, hygiene products, and extra PPE supplies. Linen closet was observed to be inaccessible to three (3) out of three (3) residents in care.