Facility Evaluation Report

Licensing Program Analyst (LPA) Albert Johnson arrived unannounced to conduct an annual inspection. LPA met with Staff and explained the purpose of the visit.

LPA inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, activity room, and outside courtyards. LPA observed sufficient furniture and lighting throughout the facility. LPA observed sufficient seven day non-perishable and two day perishable food supplies. Hot water temperature are maintained and average at 118.5 degrees Fahrenheit in resident bathroom sink, which is within the required range of 105 to 120 degrees. Fire extinguishers and smoke detectors are operational. During the tour of the facility LPA and Staff observed unlocked cleaning supplies/toxins in the residents bathroom, Staff removed the toxins during the inspection.

LPA observed centrally stored medications are kept locked and inaccessible to residents. LPA reviewed and compared resident medication vs. resident medication logs. During the medication review LPA observed R1 has not started the order for diabetic testing. R1 moved into the facility on 6/21/2022 the facility has not started checking R1's sugar levels. LPA and Staff also discovered that R2 has an order from the doctor to administer their own medication, R2 medication count was off for one medication reviewed due to no start date listed in the centrally stored log or on the medication sheet.

LPA reviewed 7 resident and 5 staff files, including criminal record clearances. First aid kit was checked and is complete. LPA observed carbon monoxide detectors in the facility. Fire drill and other drills conducted as required.

Per the Title 22, Division 6 of California Code of Regulations, deficiencies were observed during today's inspection and cited on the attached 809 D page.

Exit interview conducted and appeal rights given.