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25 | On 1/11/2024, at 2pm, Licensing Program Analyst (LPA) Arvin Villanueva arrived to this facility unannounced to conduct a quarterly case management visit. LPA Villanueva met with Administrator on record Annie Rodriguez and explained the purpose of the visit. During this visit, LPA observed 5 resident in care with 2 staff on duty.
LPA and Administrator Annie toured the facility to ensure compliance with Title 22 regulations. LPA observed 1 resident in care who was watching TV in the living room and 4 resident was in their bedrooms. The facility has an approved hospice waiver for 3 residents, and there is currently 2 residents in care on hospice. Common areas and resident bedrooms were observed to be clean, organized, and free from obstructions. Facility was observed to have emergency water and a fully stocked pantry. Room temperature was observed at 75 degrees F. Hot water temperature was measured at 108 degree F. Fridge and freezer temperatures were observed to be within regulatory standard. LPA observed the current stipulation order place in a conspicuous place in the front area of the home at the office desk.
Staff working in the home were observed to be fingerprint cleared. LPA observed staff training from June 2023 to December 2023 with topics that align with the stipulation order. LPA also reviewed 2 staff files and 2 resident files. Technical advisory was provided to the administrator to obtain PRN authorization letter from the residents' physician. During resident file review, LPA observed files do not contain PRN Authorization for each resident in care. A technical violation was given to licensee/administrator regarding hospice resident who is also have a bedridden status. During resident file review, LPA observed a medical assessment, dated 9/29/23, of 1 of 5 resident is diagnosed as bedridden. Per licensee/administrator, the nurse who assessed the resident might have assessed the resident ambulatory status by mistake. LPA reviewed previous medical assessments of the resident and revealed that the said resident was assessed as non-ambulatory. LPA provided assistant to licensee /administrator to have the resident reassess to proper ambulatory status. Note that the facility is licensed to have 1 bedridden resident in bedroom #3 of the facility sketch, but the resident is in a bedroom not cleared for bedridden. The licensee/administrator has completed 18 out of 18 hours of training related to observation change in residents, duty to obtain timely medical care, prohibited health conditions and prevention of pressure injuries. LPA also reviewed current LIC308.
Per California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies were observed during this visit. An exit interview was held with Annie Lyn Rodriguez, and a copy of the report was provided. |