Facility Evaluation Report

License Program Analyst (LPA) Shannan Hansen arrived unannounced to conduct an Annual inspection of facility. LPA met with Interim Administrator, Nancy Steers-Crist (Operations Specialist from CoBridge). There is a total of 38 residents at this full memory care facility. There are 7 residents currently on Hospice.

LPA toured the facility on 8/13/2024 at 8:30 AM with Interim Administrator. LPA observed all exits were unobstructed. Facility fire extinguishers, twelve of them (12 of 12), were last serviced 7/2024. Fire department last inspected 7/24/2024-no violations noted on inspection date. Smoke alarms are hard wired with combination carbon monoxide detectors. Resident bathrooms have grab bars as required and non-slip flooring in showers. The food supply was sufficient during today's inspection. Hot water temperature measured between 105.2 degrees F and 111.3 degrees F within Title 22 acceptable regulation of 105 to 120 degrees F in 8 of 8 resident’s bathrooms while touring facility. During tour of resident rooms LPA & Interim Administrator observed scissors, razors, tweezers, clippers, & hydrogen peroxide along with other personal hygiene products accessible to residents in multiple rooms (see pics)(see LIC809-D). While touring kitchen pantry had a large hole cut out in ceiling (see pics) and LPA discovered stove oven pilot light is having issues staying lit (see pics)(see LI809-D) Resident medications are kept locked and secured in a designated medication room to ensure they are kept inaccessible to residents in care, along with Medication Technicians using two medication carts to disperse medications, that were locked when checked at 11:10am on 8/13/2024.

LPA initiated a file review of five resident files and five personnel files but were unable to complete. LPA was also unable to review medication and will return at a later date to complete annual inspection.

The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal of rights provided..