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25 | Licensing Program Analyst (LPA) Hannah Rodgers conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by and discussed the purpose of the visit to Administrator Evelyn Cabales. The facility's license shows a maximum capacity of five (5) non-ambulatory residents. Hospice waiver for five. During today’s inspection there were four (4) residents in care.
LPA with Administrator Cabales toured the interior and exterior of the facility and inspected each room. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility contained at least 2 days of perishable food, and at least 7 days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. No toxic chemicals or poisons were accessible to clients. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per Administrator Cabales, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguishers were serviced within the last 12 months. First aid kits were complete and readily accessible. Required licensing postings were observed in visible areas of the facility.
LPA reviewed facility records. Review of resident records revealed that Resident #1 (R1) had a prohibited health condition, a gastrostomy tube. Furthermore, records reviewed revealed that Resident #2 (R2) did not have the results of a tuberculosis test on file. Confidential records were stored in locked areas.
Two (2) deficiencies were cited per California Code of Regulation, Title 22. A plan of correction was jointly formulated, and an exit interview was conducted with Administrator Evelyn Cabales whom a copy of this report, LIC809-C, and the Licensee/Appeal Rights (LIC9058 03/22) were provided.
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