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25 | Licensing Program Analyst (LPA) Hannah Rodgers, LPA David Roman, LPA Juliana Barfield and Licensing Program Manager (LPM) Lizzette Tellez conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPAs and LPM were welcomed by and discussed the purpose of the visit to Caregiver Maria Pacleb. Administrator Amsal arrived during the visit. The facility's license shows a maximum capacity of 6 non-ambulatory residents, of which 1 may be bedridden in room #1. During today’s inspection there were 5 residents in care.
LPAs and LPM with Adminstrator Amsal toured the interior and exterior of the facility, and inspected each room. Pathways were free of obstruction and slip hazards. Resident 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 resident 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 residents. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per Administrator Amsal, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguisher(s) were serviced within the last 12 months. First aid kit was complete and readily accessible. Required licensing postings were observed in visible areas of the facility.
LPAs interviewed staff and residents, and reviewed facility records. During review of resident records LPAs observed that Resident #1-4 (R1-R4), residents with a major neurocognitive disorder, did not have an updated medical assessment and reappraisal. LPAs observed that Staff #1-3 did not have proof of training and a health screening report in their files.
Three deficiencies and one technical violation were cited in accordance with CCR Title 22. An exit interview was conducted with Amsal to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.
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