Senior Care Records.

Facility Evaluation Report

Rustan Adult Residential Care Home, Daly City09/27/2024Licence 410508554

Capacity6
Census5
Date signed09/27/2024 12:06:54 PM
The inspector’s account

On September 27, 2024, Licensing Program Analysts (LPAs) Komal Charitra and Kiran Jain conducted an unannounced annual inspection. LPAs met with Caregiver, Rowenda Prado and Administrator, Leah Ruiz and explained the purpose of the visit.

LPA toured the facility inside and outside including all of client rooms, common areas & kitchen. The indoor and outdoor passageways were free of obstruction. No accessible bodies of water of fire safety hazards observed. LPA observed three shared client rooms and two staff rooms. All client rooms were observed with required furniture. Client room #2 was observed to have a closet door in disrepair and client room #3 was observed to have a broken dresser. LPAs observed a exit passageway from client room #3 to the backyard. Sliding door in room #3 was observed to have no handle to open the door and no lock on the door. Two staff rooms were observed for live-in staff with their personal belonging. Two full bathrooms were observed; one client bathroom was observed in the hallway equipped with liquid soap and paper-towels and another full bathroom in staff room 1.

Extra linen was present. First aid kit was observed present and complete. Water temperature throughout the facility measured at 127 degrees F. Living room and dining room were observed free from tripping hazards. A comfortable temperature is maintained and lighting is sufficient for comfort. LPA toured kitchen and observed two day perishable and seven day non-perishables. Sharps, chemicals and medications were observed to be unlocked an accessible to clients. Carbon monoxide monitors are working properly. All fire extinguishers have been checked and current as of May 2024. LPAs observed garage to have washer and dryer in good repair. Chemicals cabinet in garage was observed locked, however key was attached to the lock. Fire drills are being conducted and logged quarterly.

LPAs reviewed 5 client records and 4 staff records. Client records are updated, complete and signed. Staff records are complete, with training logs that have met the basic requirement. Medication review was done, and all medications are accounted for, and centrally stored medication records are updated.

Deficiencies are cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. Report was discussed with Administrator. A copy of this report and the Appeal Rights is provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction