Facility Evaluation Report

At 9:30 AM, Licensing Program Analyst (LPA) Huma Rahimi conducted an unannounced annual visit. LPA met with the House Manager, Stephen Parks and LPA disclosed the reason for the visit. LPA and the House Manager toured the facility inside and out.

It is a single story building with five (5) bedrooms, three (3) bathrooms, kitchen, garage, common areas, and outdoor areas. It has an approved fire clearance for six (6) residents, of which six (6) may be bedridden. Approved hospice waivers for six (6). Additionally, LPA observed an ADU unit with the address of 7628 Wilbur Avenue, Reseda, CA 91335, built in the property. LPA was not provided an access to the property since it was locked. Administrator informed LPA that the unit is vacant and no individuals residing at the unit.

Kitchen: At approximately, 9:45 AM LPA toured the kitchen area and observed enough supplies of staple non-perishable for minimum 1 week and perishable for 2 days at the facility. All knives and sharps observed to be locked in a kitchen drawer. LPA observed a fully charged fire extinguisher hung in the kitchen purchased on 08/30/2024. A laundry area near the kitchen contained an operable washer and dryer. Cleaning solutions were locked near the appliances.

Medications: At approximately, 9:50 AM LPA observed medications are centrally stored and locked in a moveable locked cabinet located in an office area near the main entrance. LPA did not observe a Centrally Stored Medication and Destruction Record (CSDMR/LIC 622) for five (5) out of five (5) residents. Review of R1’s medication revealed that the facility was supposed to start Ezetimibe 10 MG (High Cholesterol Medication) a new bottle on 08/15/2024. During today's visit LPA counted R1's medication and it was discovered that there was a discrepancy, and sixteen (16) extra pills were in the bottle. LPA asked the Administrator for explaining and the Administrator stated that they might have extra pills from an old bottle that was administered; however, due to the lack of documentation of Centrally Stored Medication Record (LIC 622), LPA could not verify the information with new bottle start date. A deficiency will be cited.