Pacific Sunrise Home I

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jeremiah Randle conducted an unannounced Annual required visit and an infection control inspection to the above facility. LPA was met by Raquel Tuazon, Administrator the purpose of today’s visit was explained. There are currently (4) residents in the facility, (3) are non-ambulatory (1) bed bound. The facility is a single-story structure located in a residential neighborhood. It has a ramp that goes along the west side of the facility. It consists of (5) bedrooms, (3) full bathrooms, shaded back yard, front yard, laundry room and attached garage. LPA and Administrator toured the entire facility inside and out. Documents are posted as mandated by the DPH and CCLD. INFECTIOUS CONTROL PRACTICES - LPA observed a sanitizing station at the facility entry & visitors and temperatures are logged and checked sanitizer/soap and paper towels in all the bathrooms and additional sanitation supplies are stored in hall closet and garage. LPA observed staff wearing masks, Residents private rooms will be converted to isolation rooms (if needed) trash cans with lids, cart for PPE’s, mitigation plan posted and/or in folder, Fit testing completed for staff, infectious Control Plan posted and/or in folder, Emergency infectious Plan posted, required postings throughout the facility. Visitor designated area, resident temperatures are checked and logged (as needed). Emergency contacts updated and posted; PPEs are enough for 30 days. All resident's and staff are vaccinated and boosted. OPERATIONAL REQUIREMENT - Fire clearances are incompliance. PHYSICAL PLANT ENVIRONMENTAL SAFETY - Bedrooms are occupied by residents and contain the mandated furniture. One staff bedroom. Bathrooms have nonskid mats, bars, and are clean and operational. (1) fire extinguisher is fully charged. First Aid kit complete with manual. The water temperature is at 117 degrees Fahrenheit. Linens and personal hygiene supplies are adequate. A comfortable temperature is maintained in the facility. Smoke detectors and carbon monoxide detectors are complying and operational. hazardous toxins and/or items are inaccessible to residents. No firearms are stored at facility and no bodies of water present. Medications are stored, locked and inaccessible to residents. Exit, walkways and/or passageways, front yard and back yard are free of debris and/or hazards. The facility is in good repair. STAFFING AND PERSONNEL RECORD TRAINING - 3 staff files are current with valid CPR cards, egress system operational, no volunteers at the facility. RESIDENTS REC - INCIDENT REPORT- 4 Resident files are current along with medications. RESIDENT'S RIGHTS - Internet access along with computer, visitor policy posted, PUB 475 posted. PLANNED ACTIVITIES - shaded area, indoor and outdoor activity area. FOOD SERVICE - Ample supply of perishable and nonperishable food and menu posted. INCIDENTAL M&D – The MARS is updated and complete. Resident’s medications are being given as prescribed by their physician. DISASTER PREPAREDNESS – The facility has an emergency and disaster plan, staff knows were shut off valves are located, flashlights available along with batteries, cell phones, additional emergency provisions, and conducted fire drill in April 2023. RESIDENT'S W/SHN - Some residents within facility require postural support, residents using oxygen have signs posted on doors. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe any deficiencies, therefore no citations were issued at this time An exit interview was conducted with Raquel Tuazon Administrator, a hard copy of report was provided.the state’s words, verbatim · CDSS document, Oct 12, 2023

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ana Soto conducted an unannounced Annual required and infection control visit to the above facility. LPA was met with Raquel Tuazon, Administrator and the purpose of today’s visit was explained. There are currently (2) residents in the facility. (1) residents are ambulatory, (0) are non-ambulatory, (1) bedridden. The facility is a single-story structure located in a residential neighborhood. It consists (5) bedrooms, (3) full bathrooms, shaded back yard, front yard, laundry room and attached 2 car garage. LPA and Raquel toured the entire facility inside and out. Documents are posted as mandated. Bedrooms 1-4 are occupied by residents and contain the mandated furniture. Bedroom 5 is a staff bedroom. The (3) bathrooms have grab bars and non-skid mats and are clean and operational. Smoke detectors and carbon monoxide detector were in compliance and operational. No firearms are stored at facility and no bodies of water present. Medications are stored, locked and inaccessible to residents. Ample supply of perishable and nonperishable food, linens and personal hygiene supplies are adequate, hazardous toxins and/or sharp items are inaccessible to residents, (1) fire extinguisher is fully charged. Exit, walkways and/or passageways, front and back yard are free of debris and/or hazards. The facility is in good repair. During the visit, LPA observed the facility infection control practices. LPA observed a sanitizing station at the facility entry & visitors and temperatures are logged and checked, sanitizer/soap, paper towels, in all the bathrooms and additional sanitation supplies are stored in the ????. LPA observed staff wearing masks, resident private rooms will be converted to isolation rooms (if needed) trash cans with lids, cart for PPE’s, mitigation plan posted and/or in folder, Fit testing completed for staff, and required postings throughout the facility. Visitor designated area, facility has internet & IPAD for residents to use, resident’s temperatures are checked and logged (once a day). Emergency contacts updated and posted; PPE's are enough for 30 days. All residents and staff are vaccinated and boosted According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe any deficiencies, therefore no citations were issued at this time. NO - Technical Advisories (TA) issued. An exit interview conducted with Raquel Tuazon, Administrator and a hard copy of report provided.the state’s words, verbatim · CDSS document, Nov 28, 2022

Type of visit: Case Management - Other

On 11/04/2021 around 1:00pm Licensing Program Analyst (LPA) Jose Calderon initiated an unannounced Case Management visit - Other to provide Technical Assistance to the above said facility. Today’s visit was conducted face to face with administrator Rachael Tuazon. LPA Calderon tour consisted of a single-story home, all common areas which included but were not limited to; building entrances, reception areas, office, hallways, restrooms, dining room, kitchen, pantry, medication storage and patio area. LPA Calderon also reviewed the facility's entry procedures, body temperature monitoring practices, social distancing practices, protective facial covering practices and disinfection/sanitation practices with Administrator Rachael Tuazon. The LPA Calderon also requested copies of the facility's records which includes but are not limited to Pre-Placement Appraisal’s, Admission Agreements, Identification and Emergency Information's, Reappraisals, Individual Needs and Services Plans, IPP assessments, Behavior assessments, Physicians Reports, Medication Logs, Incident Reports, Progress Notes, Hospital discharge notes for resident 1 who was transferred from facility Adorable Red beam Home on 10/30/2021 to Pacific Sunrise Home 1. On 11/04/2021 LPA Calderon interviewed Administrator Rachael Tuazon who states that she was advised that a staff member with the other facility had abused R1 and this was the reason R1 was moved to her facility. Administrator Tuazon states that she did not see any signs of abuse for R1 when she moved in and she and her staff inspected R1 for signs of abuse and could not find any. A telephonic exit interview was conducted with administrator Rachael Tuazonl and a hard copy was provided by hand for signature.the state’s words, verbatim · CDSS document, Nov 4, 2021

Type of visit: Required - 1 Year

On 10/19/2021 Licensing Program Analyst (LPA) Jose Calderon conducted an unannounced Annual required visit with a primary focus on infection control measures. LPA Calderon was met by Administrator Maria Cantoria and the purpose of today’s visit was explained. The facility is licensed to serve 6 elderly 59 years or older. There are currently 5 residents in care. There is 1 non-ambulatory resident and 4 ambulatory residents in care. The facility is a one-story structure with 5 bedrooms and 3 bathrooms, living room, kitchen and patio. LPA Calderon and Administrator toured the physical plant. There are no bodies of water or firearm/ammunition on the premises. All client rooms were checked. Beds and bedding were in good condition, adequate lighting provided, storage for client personal belongings was observed. Walls and floors were in good repair. 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 clean and operational. LPA Calderon observed the facility to be clean and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning agents, toxins, and sharps were accessible to clients. The kitchen was inspected and there is an enough perishable and non-perishable food available which is stored properly. Fire extinguisher was charged, smoke detectors and Carbon Monoxide were operable. During the visit, LPA observed the facility infection control practices. LPA observed screening protocols for visitors, staff and residents, sanitizing stations (Located in common areas and restrooms). LPA observed staff and residents were wearing face coverings, an isolation room and required postings throughout the facility. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). LPA advised the Administrator to continuously monitor the Centers for Disease Control (CDC) website and Community Care Likening Provider Informational Notices (PIN) for any updates relating to COVID-19 guidance. During today’s visit there were no deficiencies observed under California code of regulation title 22, division 6, chapter 8. Exit interview held. A copy of the report was provided to Administrator Maria Cantoria.the state’s words, verbatim · CDSS document, Oct 19, 2021