Facility Evaluation Report

On 6/20/24 Licensing Program Analyst (LPA) Maja Jensen arrived at facility unannounced to conduct a required 1 year annual visit. LPA Jensen met with Licensee Edith Rodriguez and explained the purpose of today's visit. The Licensee advised that she anticipates adding an addition to the facility in the near future.

LPA Jensen toured the grounds and observed all paths to be free of obstruction. The window screens were in good repair. There is an outdoor seating area with patio furniture and shaded areas for client use. LPA Jensen toured the interior physical plant. The facility was observed to be sanitary with all furniture in good repair. The bedrooms were observed to have all required items. There is an adequate supply if linens on hand. The bathroom water temperature is in compliance. There is non-skid flooring in the bathing area. LPA Jensen toured the kitchen and determined the facility maintains a 7 day supply of non-perishable food and a 2 day supply of perishable food. The knives, toxins and medications were observed to be locked and inaccessible to residents in care. LPA Jensen observed a variety of activities available including a piano, gardening and various board games. The facility has a first aid kit that was determined to be complete and in compliance. The smoke detector and and carbon monoxide were determined to be in good working order. The facility maintains a generator in the event of a power outage. Fire extinguisher was in compliance. There is emergency lighting, food, and water on site. LPA Jensen reviewed 3 of 3 staff files. The staff files were determined to be complete and in compliance. LPA Jensen reviewed 5 of 6 resident files and observed 4 of 5 LIC 602's to be outdated. LPA Jensen observed 3 of 5 Needs and Service Plans to be outdated. LPA Jensen interviewed 1 staff member who was adequately able to answer all questions asked. LPA Jensen interviewed 2 residents who said they were satisfied with all aspects of care. LPA Jensen requested and received a copy of the current liability insurance, the LIC 500 and LIC 308.

Deficiencies are being cited pursuant to the California Code of Regulations (CCR). Failure to correct deficiencies may result in the assessment of civil penalties. An exit interview was conducted and a copy of this report and appeal rights were provided.