Facility Evaluation Report

Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to the facility to conduct a case management visit. LPA Valerio met with facility staff Etta Mae, and explained the purpose of the visit. LPA Valerio was later met by Administrator Beatrice Clark.

05/29/2024, LPA Valerio was initially at the facility to conduct a 10-Day Complaint Investigation related to Complaint # 27-AS-20240528100935. During the facility walk through, LPA Valerio observed multiple health and safety concerns. Pictures were taken for future reference.

On top of the kitchen counter, LPA observed 2 gallon bleach containers, a spray bottle labeled bleach, and a screw driver next to the kitchen sink. On the dryer rack located near the kitchen sink, LPA Valerio observed a large kitchen knife.

During an interview with a resident, LPA observed ants crawling on the table and on the resident's hand. The resident was unaware of the ants until LPA Valerio pointed it out. According to an interview with Administrator Beatrice, the pest control service was last at the facility 6 months ago, staff clean daily, and they have a housekeeper that cleans frequently. Technical Assistance provided for 87555(b)(27).

LPA Valerio observed a nail screwed into the wall in front of a resident bathroom door and a bedroom door. The bedroom door was learned to be used for live-in care staff. Behind the door, LPA observed a rope tied to the doorknob. LPA Valerio asked Staff 2 (S2) to demonstrate the reason behind the rope and nail. S2 showed that the facility takes the rope and ties it over the nail. S2 stated it is used for staff privacy when using the restroom or inside the staff room due to the doors being unable to lock. Administrator Beatrice and Staff 2 denied that the nail and rope are used if a resident is inside. Administrator Beatrice stated she reminded staff multiple times to never install the nails and have repeatedly told them to not use it in the past. Administrator removed the rope and nails during the visit.

Per California Code of Regulations (CCR) Title 22, deficiencies are being cited today on the attached LIC 809-D page. Appeal Rights were provided. An exit interview was held with Administrator Beatrice, and a copy of report was provided to the Administrator.