Merrill Gardens at West Covina

Allegation investigated: Questionable Death.

Licensing program Analyst (LPA) Mary Flores conducted an unannounced subsequent visit regarding the above allegation. LPA met with Sherry Fischer and explained the reason for the visit. The investigation consisted of the following: On 7/12/23 LPA requested copies of staff/resident roster and conducted a health and safety check tour of the facility. LPA requested the following documents: Physician's reports, death reports, hospice documents, for resident #1-#7(R1-R7), and employment application for 3 staff that cover night shift. On 10/31/23 Administrator provided a copy of death certificate for R1. On 11/9/23 LPA Flores interviewed 1 staff over the phone, 5 staff at the facility, and delivered findings. The investigation revealed the following: Regarding allegation: Questionable death. It is alleged, on 6/9/23 Resident #1(R1) passed away suddenly and was observed well the same day. Interviews conducted with staff revealed, although there may have been concerns about the death of the resident. (CONTINUED ON LIC 9099C) Unsubstantiated It was determined that staff were aware that R1 was under hospice care and had shown a decline in condition which was conductive to R1’s death. Staff do not have concerns regarding staff that are providing care to the residents at the facility. Documents reviewed revealed the following: Facility submitted a Death Report dated 6/16/23 to the department and notes that on 6/9/23 R1 passed away at 11:25pm of coronary artery disease (CAD). Death Certificate dated 7/3/23 notes health conditions as the cause of death. Facility’s Letter Head notes R1 entered hospice on 2/11/23. Per documents reviewed R1 was actively receiving hospice services. R1’s Physician’s Report dated 2/11/23 notes, “no treatment needed for CAD as R1 is on hospice”. Outside Provider Notes - noted by hospice Skilled Nurse dated 5/31/23, 6/2/23, 6/7/23, and 6/9/23 note R1’s change in condition and show R1’s health declining. Deaths occurred at the facility between 4/26/23 to 7/1/23 were notified to the department via death reports. 6 out of the 8 deaths were of residents under hospice care due to a terminal illness or heart disease. The other 2 deaths recorder residents had a sudden change in condition and were send out to the hospital upon observing the change in condition. Per death reports both residents passed away at the hospital. Although R1 seem to have been well before 10:00pm, the hospice documents reviewed show that R1 was declining, R1's death was determined to be due to health conditions and not to other reasons. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview was conducted with Sherry Fischer and a copy of this report was provided.the state’s words, verbatim · CDSS document, Nov 9, 2023 · control 28-AS-20230711131239

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Christine Wong conducted an Annual/Required visit by using the Compliance And Regulatory Enforcement (CARE) Tools on 10/6/2023 but due to time restrains and LPA Christine Wong has returned on today's date 10/13/23 to finish the remaining three (3) domains. LPA met with Receptionist Elizabeth Hernandez who allowed entry into the facility and Shortly after, the Administrator Sherry Fischer and Resident Care Director Monica Chavez arrived and assisted with the visit On today's date, LPA inspected the three (3) domains include: Personnel Records-Training, Disaster Preparedness and Residents with Special Health Needs. 1. Personnel Records-Training: All the staff in the facility are over 18 years old, associated and fingerprint cleared with the facility. The administrator is Sherry Fischer and her administrator certificate expiration date was 3/12/23 but LPA reviewed the CCL website and its pending in our internal system. LPA reviewed all the staff files and they all have the required documents in file which included: health screening, TB test result, required training hours and updated first aid certificate 2. Disaster Preparedness: The facility has an updated Emergency Disaster Plan (LIC610E) and its updated on 6/6/23. The last fire drill was conducted on 8/29/23. The facility has two temporary alternative shelter location. Records of resident Appraisal and Needs services plans are part of Emergency training. 3. Residents with Special Health Needs: No residents in the facility with prohibited health condition. Currently there's one resident on hospice and three residents on home health. Individual Service Plan and appraisals are on resident's files for home health and hospice. No deficiencies were observed during the visit. Exit Interview was conducted and a copy of the report was provided to Administrator Sherry Fischer.the state’s words, verbatim · CDSS document, Oct 13, 2023

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Wong conducted an unannounced Required- 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. The purpose of the visit was explained to Activity Director Nicole Bermingham and shortly after the Resident Care Director Monica Chavez arrived and assisted LPA with the visit. The facility is licensed to RCFE/Dementia for age range 60 and over. Approved for 150 non-ambulatory, of which 15 may be bedridden, approved in rooms in memory care unit. Hospice Waiver approved for 15 residents. Currently, one (1) resident on hospice, zero (0) bedridden resident and three (3) residents on home health services. On today's date, LPA inspected the following domains which include: Infection Control, Operational Requirements, Physical Plant/Environment Safety, Staffing, Resident Records/Incident Reports, Resident's Right, Planned Activities, Food Service and Incident Medical and Dental. 1. Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. The facility has submitted a COVID-19 Mitigation Plan and Infection Control Plan. 2. Operational Requirements: The current plan of operation is completed. The facility has a Dementia Waiver in place. A Hospice Waiver for 15 residents is approved. A fire clearance for 150 non-ambulatory residents; of which 15 may be bedridden is in place. Liability Insurance in the amount of at least ($5,000,000) per occurrence and total amount of aggregate ($5,000,000) is in place. 3. Physical Plant and Environmental Safety: The facility is a 5 story building. There are a total of 111 apartments, 13 of those in memory care unit and 2 of the 13 apartments will be shared. On the first floor, it included Receptionist/Front Desk, Staff Offices, Theater room/Activity Room, Resident Mail box, Salon/Spa Room, Maintenance Office, Wellness Center, Dining area, Facility Kitchen, Public bathroom for Male and Female, Staff Lounge and Private Dining Room. (See LIC 809C for continuation) On the other side of the building and its included memory care unit (Garden House) and its a secured building. It includes 15 residents rooms, living room, laundry room, public bathroom, medication room and office. For the memory care unit, LPA inspected Room#100, #107 and #113. Each memory care resident apartment have the required furniture and sufficient lighting and closet space. The bathrooms are clean, sanitary and in a good working condition. All bathrooms have the required grab bar and non-skid mat. The hot water temperature in memory care residents apartments were tested between 114.9 and 115.8 degrees F and they are within the Title 22 regulation. From 2nd floor to 5th floor, they are all assisted living unit and independent living unit. LPA inspected Room#200 #202, #300 #315 #400 #415 and #506 and each resident apartment has the required furniture with sufficient closet space. Bathrooms were clean, toilets and water faucets worked properly and were properly supplied, have functional fixtures, and have secure grab bars. Emergency pull cords were observed in every resident apartment. Showers were free of mold/ mildew and non-skid mats or strips were properly in place. The hot water temperature were tested between 114.6 and 117.1 degrees F which is within the Title 22 regulation. LPA also inspected the carbon monoxide detectors in the facility and they are working properly. 4. Staffing: Facility has sufficient staffing for care and supervision to the residents. 5. Residents Records/Incident Reports: LPA inspected 12 residents files and they all have the required documents in file which included : admission agreements, Physician's Reports, Appraisal, TB clearance, Functional Capability Assessment, Physician's Orders, medical consent, and medication records. 6. Resident's Right: LPA observed the required posters posted near the Theater Room which include Long Term Care Ombudsman, Community Care Licensing Complaint and Personal Right Poster. The residents also have internet service for at least one internet access device for residents to communicate with their family members or physician. 7. Planned Activities: Sufficient space to accommodate both indoor and outdoor activities was observed. An activity calendar is posted and LPA reviewed the calendar for both Assisted Living and Memory Care Unit. The facility does have an active Resident Council. 8. Food Service: Currently the facility has no resident is on a modified diet. The facility has sufficient 2 days perishable and 7 days non-perishable food supply and emergency food supply stored and locked in the quiet room in the memory care unit. Sanitation practices and kitchen cleanliness was observed. 9. Incidental Medical and Dental: LPA inspected six (6) residents' medication which include (2) from Assisted Living and four (4) from Memory Care Unit and they are centrally stored and locked in the medication room and they are seemed accurate and updated and also contained 30 days supply of medication. The facility would also provide medical and dental transportation if needed. Due to time restraints, LPA was not able to complete all the domains today, LPA will come back another time to review which include Personnel Records-Training, Disaster Preparedness and Residents with Special Health Needs. No deficiencies were observed on today's visit. Exit Interview Conducted and A copy of the report was provided to Monica Chavez.the state’s words, verbatim · CDSS document, Oct 6, 2023

Allegation investigated: Facility failed to provide resident records.

Licensing Program Analyst (LPA) Nune Margaryan conducted an initial 10-Day complaint visit to investigate the above allegation. The purpose of the visit was discussed with Business Office Director Patricia Colin. The investigation consisted of the following: LPA obtained copies of staff & resident rosters, interviewed Staff 1 (S1) and requested Resident 1 (R1) file. Resident (R1's) file was reviewed. The following documents were obtained pertaining to R1:Identification and Emergency Information/Face Sheet, Admission Agreement, Physician Report, Pre-Placement Appraisal Information, Advance Healthcare Directive, Consent for emergency medical treatment, Personal Rights. See LIC 9099C for report continuation. Substantiated Allegation: Facility failed to provide resident records: It is alleged that on Thursday, September 06, 2023, the facility received a formal records request via Federal Express to obtain a copy of resident (R1's) records. The request was made by the resident's legal representative. As of today September 18, 2023, the documents had not been provided. They were due Monday, September 11, 2023. Business Office Director confirmed the records request was received on late September 06, 2023. Business Office Director stated that documents were provided to Facility Legal Department on September 07, 2023 for review. Business Office Director stated that is the facility policy and usually they get back from them in a 24 hours. Copy of email was provided to LPA that shows email sent to Legal Department on 09/07/23 at 9:29 am. Business Office Director was not able to provide any confirmation that requested documents were sent to the resident's legal representative. Based on interviews and record review, the findings indicate that the facility did not provided the documents as of 09/18/23. Therefore, there is sufficient evidence to corroborate the allegation. Based on record review and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Deficiency is being cited according to Title 22, Division 6 Health and Safety Code, Chapter 3.2 Residential Care Facilities for the Elderly Article 02.5 Resident's Bill of Rights. See LIC 9099D. Exit interview was conducted with Business Office Director. A copy of the report and appeal rights were provided.the state’s words, verbatim · CDSS document, Sep 18, 2023 · control 28-AS-20230911162517

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.269(a)(21) · Plan of correction due date: Sep 25, 2023

Enumerated rights; severability.Residents of residential care facilities for the elderly shall have all of the following rights:To have prompt access to review all of their records and to purchase photocopies. Photocopied records shall be promptly provided, not to exceed two business days, at a cost not to exceed the community standard for photocopies.This requirement was not met evidenced by: Based on record review, the facility received a formal request on 09/06/ 2023 for records of R1 and failed to provide the records within 2 business days, as required per regulation; which poses a potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Sep 18, 2023

Plan of correction: Business Office Director agreed to submit a written plan of correction addressing resident records, enumerated rights; severability, and facility procedures regarding resident records request. Submit by POC due date.

Allegation investigated: Staff have not fixed residents shower Staff speak disrespectfully to residents Staff did not meet residents needs

Licensing Program Analyst (LPA) Erik Zaragoza conducted a follow up complaint investigation regarding the allegations listed above. LPA met with Sherry Fischer the Administrator and explained the reason for the visit. The investigation revealed the following: during the initial visit conducted on 01/20/2022, LPA Kruz Long LPA obtained/reviewed a copy of the Staff/Resident rosters, work orders and interviewed two staff members in the conference room. During today's visit, LPA Zaragoza interviewed Residents 1 - 12 (R1, R2, R3, R4, R5, R6, R7, R8, R9, R10, R11, R12), and Staff #1 - 6 (S1, S2, S3, S4, S5, S6). LPA also obtained copies of the following documentation: Currest Staff and Resident Rosters for the facility, work orders for R1 and R2's room, and also the admission agreement for R1 and R2. The investigation revealed the following: in regards to the allegation "Staff have not fixed resident's showers," it is alleged that the Maintenance Department had taken six months to fix the leaking shower head in the resident's restrooms, which was fixed on 1/19/2023. Unsubstantiated During interviews with the Maintenance Director and the Administrator, it was shown in the facility's work order system that the most recent work order submitted for R1 and R2's room were from 3/7/2023, and therefore there was no work order submitted around the time that they requested their leaking shower head to get fixed. Additionally they explained that when a maintenance work order is received by them, it typically takes three (3) days to one (1) week to get fixed at the latest. R3 - R12 stated that they have never had any issues with maintenance when they have submitted work orders, and that their issues have been fixed in a timely manner. Five (5) out of (6) staff could not corroborate the allegation that it takes longer than one week at most to fix any type of maintenance issue in resident rooms. In regards to the allegation "Staff speak to residents disrespectfully", it is alleged that staff have spoken down to residents in a condescending and disrespectful manner before and has caused tension between the residents and the staff. During interviews with the Administrator, she explained that neither she nor any of the other staff members of the facility have treated the residents in a disrespectful manner. The administrator states that the facility always reminds staff of their obligation to provide 5-star customer service to the residents and provide training as well to ensure that all residents are treated with dignity and respect when working with residents. R3 - R12 all stated that they have never witnessed staff being rude or disrespectful to the residents in any way, and R6 stated that that the staff provide exemplary and wonderful service to all the residents that live in the facility. Five (5) out of six (6) Staff members could not corroborate the allegation that they have ever witnessed staff speaking to residents in a rude or condescending manner. In Regards to the allegation "Staff did not Meet Resident's Needs", it is alleged that staff have ignored the needs of residents and allowed them to wander, in particular R12 who lives in the memory care unit, and also because the grab bars that are installed in all of the resident's showers are inadequate and could potentially lead to a resident falling and thus leading to serious injury because the grab bars do not follow the American's with Disabilities Act (ADA) standards. Administrator explained that the needs of residents in the memory care unit are never ignored, and that she has conducted research with the facility's legal team who concluded the grab bars of the facility do meet the ADA standards. Interviews with R3 - R12 revealed that none of them had witnessed the needs of the memory care unit being ignored by the staff, and that they were all satisfied with the grab bars in their restroom, however R6 and R7 stated that they could foresee it being an issue with shorter residents. Five (5) out of six (6) staff members could not corroborate the allegation that the needs of memory care residents were not being met. Based on statements and interviews conducted with staff, clients, review of client files and facility file records, there was not enough supportive evidence to concur with the reported allegations. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. Exit interview held, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Aug 11, 2023 · control 28-AS-20230113110457

Allegation investigated: Facility staff are not allowing resident council meetings to be conducted in private. Facility staff are racially altering the bylaws of the resident council.

On 6/29/23 at 8:32 a.m., Licensing Program Analyst (LPA) Jewel Baptiste conducted an unannounced complaint visit to the facility. Upon arrival LPA met with (S1) and explained the purpose of the visit. The General Manager Sherry Fischer arrived at 8:50 and joined the visit. During today’s visit LPA toured the facility with the General Manager. LPA obtained resident roster, staff roster, resident council by laws, resident council memo, Resident council flyers, resident council correspondence with the General Manager, Admissions agreement page 13, and plan of operation (operations policy guide). LPA also interviewed: Administrator and a total of two (2) staff who shall be referred to as S1, and S2. LPA interviewed a total of 10 residents who shall be referred to as: R1 through R10. Report continued 9099c Unsubstantiated The investigation reveals the following: Regarding "Facility staff are not allowing resident council meetings to be conducted in private”. LPA interviewed the General Manager and confirmed facility staff attend resident council meetings by invitation only. The General Manager further stated the facility has not attended a resident council meeting in the last year. 2 out of 2 staff denied the allegation stating they are not allowed to attend the resident council meetings without an invitation. 8 out of 10 residents stated staff are not allowed to attend resident council meetings but has joined the meetings when invited. 1 out of 10 residents stated they believe another resident was sent to the meetings on behalf of the facility. 1 out of 10 residents stated they have seen the General Manager attend the resident council meetings in the past, but they are unsure if they were invited. The investigation reveals the following: Regarding " Facility staff are racially altering the bylaws of the resident council". it is alleged that the facility was able to radically alter the bylaws of the resident council. The General Manager denied the allegation, stating the first council president created he bylaws and the facility is not involved with the resident council bylaws. 2 out of 2 staff denied the allegation stating the facility is not involved with the bylaws of the resident council. 5 out of 10 residents stated the bylaws was created by the resident council without facility involvement. 3 out of 10 residents stated they have no knowledge of the facility altering the bylaws. 1 out of 10 residents stated some items was removed from the resident bylaws because it infringed upon the facility’s operational rights. 1 out of 10 residents stated they heard some sections of the resident council bylaws was overruled by facility general manager and was not added to the resident council bylaws. Based on LPA's interviews, investigation revealed: Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview conducted with sherry Fischer and a copy of this record provided.the state’s words, verbatim · CDSS document, Jun 29, 2023 · control 28-AS-20230622164039

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced required Annual Visit focusing on COVID-19 Infection Control Practices. LPA was met by Administrator Sherry Fischer and explained the purpose of the visit. Staff #1 (S1) later joined LPA and Administrator Fischer to assist with tour of physical. This is a 5-story building located on a main intersection. This facility is licensed to serve residents over 60 years old. This facility has an approved Dementia Care Plan in its plan of operation and accepts/cares for residents with dementia. The facility has a fire clearance approved for 150 non-ambulatory residents of which 15 may be bedridden. Garden House (Memory Care Unit) is approved for delayed egress, secured perimeter, and secured locked perimeter. Hospice Waiver approved for 15 residents. There are a total of 111 apartments, 13 of those in memory care unit and 2 of those 13 apartments will be shared. The facility has central air and heating accommodations LPA OBSERVATIONS: · 1st floor consisted of Garden House (Memory Care Unit), Dining room, Lobby, Activity room,Administration office, Theater, Wellness room and Salon. Garden House entrance is only accessible by pin pad access. LPA observed a kitchenette and living room area. Signage promoting cough/sneeze etiquette was observed in various locations throughout this area. Resident rooms have signal systems located in each bathroom and facility phones to call the front desk. The signal system was tested and is operable. Extra supply of chemicals and cleaning supplies are kept in a maintenance office located on the 1st floor and was observed to locked and inaccessible to residents. Kitchen area was observed after lunch time. The walk in refrigerator was observed to be at 45 degrees Fahrenheit and the walk freezer at 0 degrees Fahrenheit. LPA observed sufficient 2-day perishables and 7-day non-perishable foods as required. LPA observed perishable foods stored in covered containers at the appropriate temperatures. No pesticides or poisons were stored in the food areas. Storage areas for cleaning solutions, toxins, knives, and hazardous items were secured and made inaccessible to residents. ·2nd floor consisted of 34 resident rooms. Resident room #201 was observed to be clean and contained the required furnishing and linens. Water temperature in this bathroom was measured at 118.9 degrees F which is in the required 105 – 120 degrees F. Resident room #203 was observed to be clean and contained the required furnishing and linens. Water temperature in this bathroom was measured at 119.8 degrees F which is in the required 105 – 120 degrees F. Grab bars were observed near toilets and showers. Emergency pull cords were observed in every resident apartment. · 3rd floor consisted of 34 resident room. Resident room #305 was observed to be clean and contained the required furnishing and linens. Water temperature in this bathroom was measured at 120.0 degrees F which is in the required 105 – 120 degrees F. Resident room #315 was observed to be clean and contained the required furnishing and linens. Water temperature in this bathroom was measured at 117.5 degrees F which is in the required 105 – 120 degrees F. Grab bars were observed near toilets and showers. Emergency pull cords were observed in every resident apartment. · 4th floor consisted of 24 resident rooms. Resident room #412 was observed to be clean and contained the required furnishing and linens. Water temperature in this bathroom was measured at 116.6 degrees F which is in the required 105 – 120 degrees F. Resident room #422 was observed to be clean and contained the required furnishing and linens. Water temperature in this bathroom was measured at 118.2 degrees F which is in the required 105 – 120 degrees F. Grab bars were observed near toilets and showers. Emergency pull cords were observed in every resident apartment. · 5th floor consisted of 10 resident rooms. Resident room #506 was observed to be clean and contained the required furnishing and linens. Water temperature in this bathroom was measured at 119.3 degrees F which is in the required 105 – 120 degrees F. Resident room #510 was observed to be clean and contained the required furnishing and linens. Water temperature in this bathroom was measured at 119.8 degrees F which is in the required 105 – 120 degrees F. Grab bars were observed near toilets and showers. Emergency pull cords were observed in every resident apartment. A shaded area with chairs is provided to the residents was observed on the roof. · Several fire extinguishers were observed throughout the facility. Smoke detectors were observed throughout the facility along with attached carbon monoxide detectors. Doors, exits, hallways, and passageways were clear and free of obstruction. There are no pools or bodies of water in or around the facility. Extra PPE supplies were secured inside Resident Care Office. Several first aid kits were observed throughout the facility which included all required supplies. Last fire drill was conducted on 02-16-23 at 6pm. Administrator certificate (6025678740) for Sherry Fischer was observed and expires on 03-12-23. No deficiencies were observed during visit. An exit interview was conducted, and a copy of this report was provided to the Administrator Fischer.the state’s words, verbatim · CDSS document, Feb 17, 2023

Allegation investigated: Resident is financially abusing another resident in care.

Licensing Program Analyst (LPA) Kruz Long conducted a complaint investigation at the facility. Upon arrival, LPA met with Sherry Fischer (Administrator) and explained the purpose of the visit. During today's visit, LPA obtained a copy of the Staff/Resident rosters, Resident #1's Physician report and Capability Evaluation, interviewed Staff #1 in the conference room and attempted to interviewed Resident #1 (R#1) and Resident #2 (R#2). In regards to the allegation: Resident is financially abusing another resident in care. LPA reviewed R#1's Physician report which indicate R#1 is able to manage own cash resources. A review of R#1's Capability Evaluation indicate R#1 has no impairments in regards to making own decisions. Interview with Staff #1 indicate R#1 is capable of handling R#1's finances and is not aware if R#1 is a victim of financial abuse. Interviews with R#1's family members indicate there is no proof of financial abuse but suspect potential future financial abuse. Continue to LIC9099.... Unsubstantiated Based on LPA's interviews and record review, the investigation revealed: Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. Exit interview conducted with Sherry Fischer and a copy of this report provided.the state’s words, verbatim · CDSS document, Dec 27, 2022 · control 28-AS-20221220102958

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) David Sicairos conducted an unannounced annual visit using the Infection Control Evaluation Tool. LPA met with Patricia Colin and explained the reason for the visit. Physical Plant was toured, sample record of medications were reviewed, and food supply was inspected. The following was observed/inspected: LPA and Ms. Colin toured the facility which included the following: Mailroom, Beauty Salon, Exercise Room, Medication Room, Movie Theater, Activity Room, Dining Room, Kitchen, and Memory Care Unit. There is a shaded seating area for the residents located in the 5th floor open area. Passageways and exits are free of obstruction. The water temperature was tested in a random selection of resident bathrooms in each floor and measured between 110F - 114.9F which is within the required 105F - 120F. Resident bedrooms have the required furniture such as bed frames, dressers, lamps and chairs. Bedrooms also have sufficient closet space. Resident beds have the required linen and the linen is in good condition. Smoke detectors and carbon monoxide detectors were observed throughout the facility and in each resident apartment and were tested and operable during the visit. LPA observed multiple fire extinguishers throughout the facility which were fully charged. Kitchen appliances are clean and were operating at the time of the visit. Sharps are locked in the kitchen and are inaccessible to residents. Cleaning supplies and toxins are locked and are inaccessible to residents. Multiple First Aid kits were inspected and were fully stocked with current manuals. Signs are posted throughout the facility to promote hand washing, cough/sneeze etiquette, and physical distancing. Sufficient supply of 2 days perishable & 7 days non-perishable foods were observed. 6 resident medications were randomly selected for review. Medications are centrally stored in the medication room. Medications are documented properly and given as prescribed. Staff and Resident files were not reviewed during today's visit. Per California Code of Regulations, Title 22, and California Health and Safety Code, there were no deficiencies observed during the visit. Exit interview held and a copy of the report was provided.the state’s words, verbatim · CDSS document, Oct 7, 2021