Facility Evaluation Report
On January 15, 2025, Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to conduct a required annual inspection. LPA met with Administrator and explained the purpose of the visit.
Today's visit, LPA and Administrator conducted a tour of the facility. Areas toured included but not limited to: five residents bedrooms, staff room, two bathrooms, laundry room, pantry, kitchen and the common areas. LPA observed sharps and toxins being locked and secured. LPA observed fire extinguisher present with service date of June 5, 2024. LPA observed active Administrator Certificate present with expiration date of 09/27/25. LPA observed facility having 2+ days of perishable and 7+ days of non perishable foods.
LPA and Administrator discussed that since staff room has the emergency exit door for the non ambulatory rooms, staff room shall be unlocked and free of medications, sharps and toxins. If wished to store the following, it shall be properly stored to be inaccessible to residents in care. LPA and Administrator discussed that Emergency Disaster Plan is to be reviewed and updated annually by the facility. LPA and Administrator discussed quarterly fire and earthquake drills to be conducted.
File review conducted for three personnel and six residents records. LPA observed no LIC 602 for R1 prior to R1's admission. R1 is residing in an ambulatory only room. LPA and Administrator discussed that residents with dementia and/or any walking assistance such as crane, walker, wheelchair cannot reside in the ambulatory only room unless on hospice.
Deficiencies observed. Please see LIC 809-D.
Exit interview conducted and copy of report and appeal rights provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction