Facility Evaluation Report

Licensing Program Analysts (LPA) Sarah Hurt and Brianna Miranda conducted an unannounced visit today for the facility’s annual inspection. LPA met with facility staff Pamela Pinnock, Continual Administrator's Certification for Administrator Lacy Vincent is 04/25/2024. There are currently 4 residents who reside at this home and there is 0 residents on hospice at this time. LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, activity rooms, medication storage, kitchen, garage and outdoor areas. Bedrooms were clean and in good repair. There is a locked storage for medications. Food supply is adequate for 2-day perishable and 7-day nonperishable.

Smoke alarms were tested and are operational. The home has a carbon monoxide detectors. Water temperature was tested at 129 degrees. First Aid kit is on site and is not complete. LPA's were not provided access to facility staff or client records. LPA's were not able to determine any resident diagnosis or resident needs as client records are not available. LPA's are not able to review staff training as Personnel records are not able for review. Staff 1 present was not able to provide proof of required First Aid training. Resident 1's Centrally Stored Medication log is not properly maintained, and medications are not being given due to being out. LPA's observed multiple facility window screens with tears and not in good repair. LPA's observed several expired food items in facility pantry. LPA's observed facility Resident 1 outside and needing constant supervision along with 2 other residents present. LPA's observed a sliding lock more than 6 feet high on the inside front door out of resident reach which is a potential fire clearance hazard. LPA's were not able to review facility Disaster Plan 610E or log of quarterly disaster drills.

The following deficiencies observed or cited during today's inspection per California Code of Regulations, Title 22.

LPA's requested the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing.

Exit interview conducted with Facility Staff Pamela Pinnock and copy of report left at facility