Facility Evaluation Report
Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced required Annual Inspection at the above-named facility. LPA met with Dorota Lositzki, Administrator.
This is a one-story home licensed as a Residential Care Facility for the Elderly (RCFE) with a dementia diagnosis. The facility has been approved for a hospice waiver for 6 residents and has a fire clearance for 6 non-ambulatory residents, one of which can be bedridden. LPA explained the purpose of the visit and toured facility with Administrator Lositzki.
Upon arrival, there were 3 residents in care with one caregiver and one administrator on duty. There are three (3) residents currently on hospice.
Upon entrance into the residence, there is a walkway leading to the front door, garden areas, and a covered patio that surrounds the facility. The facility has a garage used for storage. There are no fountains or bodies of water.
The facility consists of a living room, dining area, kitchen, and five bedrooms. The entrance into the residence leads into the living and dining area. The kitchen consists of a refrigerator, microwave, sink, stove, oven, dishwasher, an air fryer, a hot water dispenser, and a crock pot. Trash and recycling bins are kept in a pullout drawer.
All required CCL posters and signage are posted near the entrance and in the hallway. Personnel files, Residents’ files, and medications are kept in locked cabinets in the dining area. Sharps are kept in a locked kitchen drawer and inaccessible to residents in care. Perishable foods for 2 days and non-perishable foods for 7 days are kept on hand for the residents.
At approximately 11:55 am, LPA observed a medication bubble pack of Furosemide 20mg tablets and a medication cup with 3 medications on the kitchen counter. At the time of the observation, there were two residents sitting at the dining table approximately 6 feet from the medication bubble pack and the medication cup. No staff were in the dining area at the time of observation. Please continue to 809-C, Pg 2 .
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction