Facility Evaluation Report

On 10/24/24, Licensing Program Analyst (LPA ) arrived unannounced to this facility to conduct a case management visit. LPA initially met with staff on duty (S1) and stated the purpose of the visit. Beatrice Clark, Administrator (AD) was notified of the visit and arrived shortly after. Present during today's visit were 5 residents in care with 1 staff on duty (S1).

The purpose of this visit is to cite deficiencies found during a complaint investigation visit (complaint #27-AS-20241017164426) on 10/24/24. During this visit, LPA and AD conducted an inspection of the facility including resident bedrooms, bathrooms, kitchen, dining, livingroom, garage and outside perimeter.

During the inspection of the kitchen, LPA observed cleaning chemicals stored under the sink. The storage under the sink does not have a lock and the chemicals are accessible to residents in care. S1 removed the cleaning chemicals and stored them in a locked closet in the hallway leading to the garage door. During an inspection of the bathroom located in the resident bedroom hallway, LPA observed 2 disinfectant sprays and a cleaning spray bottle under the bathroom sink storage. This storage was unlocked and accessible to residents in care. S1 removed the chemical items and store them inside a locked closet in the hallway leading to the garage door. Photos were taken for reference. LPA also inspected the kitchen pantry and refrigerator and freezer. LPA did not observed medications stored the refrigerator.

LPA measured the hot water in the hallway bathroom and was measured at 123*F. LPA and AD measured the hot water in the master bathroom and was measured at 123*F.

LPA and AD also inspected the outside of the facility. Fence and gates were observed to be in good repair at this time. LPA observed the gate was locked by the evidence of the latched being tied with a string. AD attempted to loosen up the tie but were not able to. Per AD there was a former resident who tends to climb up the fence but has moved out more than a week ago. AD stated they forgot to unlock the gate. During this visit, S1 cut and removed the string off the gate latch.

Per California Code of Regulations (CCR) Title 22, deficiencies are being cited today on the attached LIC 809-D page.

An exit interview was held with Administrator Beatrice, and a copy of report and appeal rights were provided.