Facility Evaluation Report

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required 1 Year visit and met with Preet Kourl, Administrator.

During visit, LPA Marrufo toured the facility inside and out. LPA Marrufo toured the facility kitchen area and observed there to be a perishable food supply of at least two days and a non-perishable food supply of at least seven days. LPA Marrufo observed the first aid kit and found it to be complete.

LPA Marrufo toured 7 resident living units. Each living unit had working lights and available bedding and storage areas for clothing. LPA Marrufo toured the bathrooms in the 7 toured resident living units and two hallway bathrooms and observed each bathroom had working lights and available soap and paper towels. The water temperatures in the bathrooms ranged from 110 F to 119 F.

LPA Marrufo reviewed the Centrally Stored Medication and Destruction Records (CSMDR) for residents R1-R7. R1's CSMDR had one missing medication, one medication entered with the wrong prescription number, and four medications with no start date. R2's CSMDR had a medicatoin with the incorrect expiration date. R4's CSMDR had a medication with an incorrect expiration date. R6's CSMDR had a medication with the wrong prescription number. R7 had two medications that were missing a start date.

LPA Marrufo reviewed 7 resident records and 7 staff records and found them to be complete.

The facility maintenance record indicates the last smoke detector testing occurred on 11/09/2023. The last emergency disaster drill was conducted on 03/18/2024.

A deficiency was cited as per California Code of Regulations Title 22. See LIC809-D for more information. This report was reviewed with Administrator Preet Kourl and a copy of this report and appeal rights were provided.