Facility Evaluation Report

Licensing Program Analyst (LPA) Jessica Cho arrived at the facility unannounced for the purpose to clear the remaining deficiencies cited on July 12, 2024 from 8:30am -10:40am. Administrator Rebekah Buboi was advised of the visit by telephone approximately 8:25am and arrived on premise at 9:21am.

Deficiency cited under Title 22 Regulations 87303 Maintenance and Operation (a)The facility shall be clean, safe, sanitary and in good repair at all times. - The electrical covers were replaced by the Admin during the visit and the wall/trim was observed to be completed upon arrival.

Deficiency cited under Title 22 Regulations 87618 Oxygen Administration- Gas and Liquid (b) (3) Ensuring that the use of oxygen equipment meets the following requirements: (B) “No Smoking-Oxygen in Use” signs shall be posted in the appropriate areas. - Signs were posted in front of the residents' bedrooms and the front door.

Deficiency cited under Title 22 Regulations 87705 Care of Persons with Dementia (c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (5) Each resident with dementia shall have an annual medical assessment as specified in Section 87458, Medical Assessment, and a reappraisal done at least annually, both of which shall include a reassessment of the resident's dementia care needs. - R1's Physician's Report has been updated.

Facility has complied with the terms of the plan of correction. The deficiencies are now cleared.

An exit interview was conducted with Administrator Rebekah Buboi, and a copy of this report including the Letter of Deficiency Citations Cleared were provided at the end of the visit.