Coastal House

Type of visit: Required - 1 Year

On 11/02/23, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced annual visit using the full CAREs tool. LPA met with Care Staff, Evelyn Navarro, and the purpose of the visit was explained. The facility is licensed to serve 6 elderly residents aged 60 and above. The facility has a fire clearance for 5 non-ambulatory and one bedridden, and an approved hospice waiver for five (5) residents. Currently there are four (4) residents residing at the facility. Physical Plant/Structure LPA toured the facility with Care Staff, Evelyn Navarro. The facility is a single-story structure located in a residential neighborhood. It consists of the following: four (4) resident rooms, two and a half (2.5) bathrooms, living area, dining area, kitchen, a detached office area in the backyard, a detached locked storage area and an outside shaded patio area with an umbrella and ample seating. All walkways and exits around the house were observed clean, clear, and free of obstructions, debris, and hazards. LPA did not observe any bodies of water on the premises. Bedrooms LPA inspected all bedrooms and found they contained the required furnishings. All rooms had a bed, dresser, nightstand, chair, and adequate storage space for resident’s personal belongings. All beds had the required linens including a mattress pad, fitted sheets, blanket, comforter, and pillow. LPA observed an ample supply of linens in good repair stored in cabinets in the hallway. All bedrooms had ample lighting. Bathrooms The bathrooms were found to be within Title 22 regulations and were operational. All showers had nonskid mats, a shower chair, and secured safety handrails. The water temperature measured between 110.5-degress and 113.6-degrees Fahrenheit. LPA observed an ample supply of towels and wash clothes stored in a cabinet in the hallway. LPA observed an ample supply of hygiene supplies and incontinent products secured in a locked storage area in the backyard. Continued on LIC809-C Kitchen The kitchen was inspected. All appliances were observed to be operational and in good repair. LPA observed an ample supply of cookware, dishware, and cutleries. LPA observed a 3-day supply of perishable and 7-day supply of non-perishable food available and properly stored and labeled. All cleaning supplies are secured in a locked cabinet under the kitchen sink. All sharps are secured in a locked drawer in the kitchen. LPA observed emergency food, canned goods, extra refrigerator/freezer, and sanitary supplies secured in a locked storage area in the backyard. The washer and dryer are located in the kitchen. Common Rooms LPA inspected all common areas. LPA observed the facility to be appropriately furnished at the time of visit. LPA observed reading materials, games, and activities stored in the dining room. LPA observed all hallways and walkways were clean, clear, and free of obstructions and hazards. The facility was maintained at a comfortable temperature. Medications All Centrally Stored Medications are secured in locked drawer, and cabinet in the kitchen. LPA reviewed the medication and MARs for four residents. All four (4) resident’s MARs and medication are consistent with properly documented records. Safety All smoke detectors and carbon monoxide detector are operational. LPA observed two (2) fully charged fire extinguisher, one in the kitchen and one in the living room. All exits are clearly marked. LPA observed a facility sketch with all exits, evacuation routes, and shut off valves posted in the facility. The facility has a working landline telephone. All mandated signs were posted throughout the facility. Infection Control During the visit, LPA observed the facility infection control practices. LPA observed screening protocols for visitors, staff, and residents, sanitizing stations in common areas and restrooms. LPA observed all staff wearing masks. A 60-day supply of PPEs was observed secured in a locked storage area in the backyard. LPA observed all mandated infection control posters were posted. File Review/Interviews LPA will conduct file reviews at a later date. LPA interviewed two (2) staff and they were able to answer questions regarding policy, procedure, resident care, and resident personal rights. Deficiencies cited under California Code of Regulations, Title 22, Division 6, Chapter 8. See LIC809-D An exit interview was conducted with Care Staff, Evelyn Navarro, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Nov 2, 2023

Type of visit: Required - 1 Year

On 08/30/2022, Licensing Program Analyst (LPA) Don Senaha conducted an unannounced annual required visit with a primary focus on Infection Control measures using the new CARE Inspection Tool. LPA was met by caregiver Cuthburt Martinez and explained the purpose of today’s visit. The facility is licensed to serve six (6) elderly residents ages 60 and above of which five (5) can be non-ambulatory. The facility has a hospice waiver for five (5) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: four (4) resident rooms, two and a half (2.5) bathrooms, living area, dining area, kitchen, a detached office area in the backyard, a detached locked storage area and an outside shaded patio area with an umbrella and ample seating. All four (4) residents were in the facility at the time of the visit of which one (1) resident is receiving hospice care. LPA and caregiver Cuthburt Martinez toured the physical plant. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting provided, storage for resident personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were operational. The water temperature met Title 22 regulations and measured between 108.0 F and 113.4 F in the bathrooms and kitchen sink. There is driveway leading up to the house and the side of the house has a locked storage area for tools and supplies. The second storage area has extra sanitary supplies, PPE, emergency food, canned goods and an extra refrigerator/freezer for food storage. The washer and dryer is located in kitchen area. Evaluation Report Continues on LIC 809-C LPA observed the facility to be appropriately furnished at the time of visit. LPA observed cleaning supplies and toxins under the kitchen sink in a locked cabinet. The kitchen was inspected and there is sufficient perishable and non-perishable food available and properly maintained. There are two (2) fire extinguishers fully charged with one in the living room area and the other in the kitchen area. Smoke detectors and carbon monoxide were tested and operational. A review of Medication Administration Records (MAR) was maintained in order and accurate. There was a first aid kit available stored in the kitchen. During the visit, LPA observed the facility infection control practices. LPA observed screening protocols for visitors, staff, and residents, sanitizing stations in common areas and restrooms. LPA observed all mandated inspection control posters were posted. Advisory Notes – There was one (1) technical advisories issued. See LIC9102TA. There no deficiencies cited during this inspection visit. An exit interview was conducted with caregiver Cuthburt Martinez and Administrator Claudia Preciado on the phone and a copy of this report was provided to caregiver Cuthburt Martinez.the state’s words, verbatim · CDSS document, Aug 30, 2022

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.