Folsom Senior Retreat

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Lavinia Muscan arrived on Wednesday July 12, 2023 to conduct the annual inspection. During today's annual inspection, the Compliance and Regulatory Enforcement Tool was used. LPA reviewed resident (3) and staff files (2). All resident files contained the required paperwork. All staff files contained the required paperwork. All staff have current first aid and CPR training. Facility was clean and well organized. All required posting were observed. Staff training contained the required initial training. LPA and Administrator Iiona Timofey toured the facility together to ensure the health and safety of residents in care. The areas toured included resident rooms, bathrooms, kitchen, common areas and outside area. The food supply is within compliance, 2 days of perishable and 7 days worth of non-perishable food items. Grab bars were present at the toilet and in the shower. All exits were unobstructed. The administrator's certificate is current. There is a gate for emergency access. LPA checked the kitchen area for the ability to prepare and store food. Knives and Sharp objects found to be locked . LPA observed cleaning products and other toxins to be locked away. LPA observed the area used for medication to be locked and inaccessible to residents. LPA observed smoke detectors and carbon monoxide detector at the care home are operational. Fire extinguisher is ready for emergency use. Water temperature is within compliance. In the areas toured, there were no health or safety violations observed. LPA requested a copy of the LIC500, LIC610E and current liability insurance to be sent to the Department by end of the month. Exit interview conducted. A copy of this report was printed and given to Administrator.the state’s words, verbatim · CDSS document, Jul 12, 2023

Type of visit: Required - 1 Year

On 7/20/2022 Licensing Program Analyst (LPA) Lavinia Muscan, arrived at the facility unannounced to conduct an annual visit using the infection control tool visit. LPA met with Facility Administrator, Ilona Timofey and explained the purpose of the visit. Prior to initiating the visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPA ensured she used hand sanitizer shortly after entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. Additionally, LPA was screened by Caregiver. LPA and Administrator toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, resident bedrooms, outside area and common restrooms. Facility has a 2 day perishable and a 7 day non-perishable amount of food. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA and Administrator completed the infection control domain and facility was found to be in substantial compliance at this time. Administrator agrees to send in LIC500 and liability insurance. No deficiencies are being cited as a result of todays inspection. Exit interview conducted and copy of report left at the facility.the state’s words, verbatim · CDSS document, Jul 20, 2022

Type of visit: Prelicensing

Licensing Program Analyst (LPA) K. Hiratsuka, arrived at the facility announced on 07/12/2021 to conduct an announced prelicensing visit. This facility is undergoing a change-of-ownership. LPA met with Facility Representatives ILona and Alex Timofey and explained the purpose of the visit. Prior to initiating the prelicensing visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; contacted Facility Representative and completed a facility risk assessment. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. Additionally, LPA was screened by Alex Timofey. This facility has a fire clearance for all non-ambulatory. The front entrance opens to a small foyer. To the immediate left is a private resident room and to the immediate right is a private resident room. Across the main entrance is one of two common areas and to the right of the sitting area is the kitchen. Behind the kitchen is a doorway that leads to an office, a door leading to the garage, and a second door leading to the caregiver room that has a full private bathroom. To the left of the entrance and past the resident room is a hallway that leads to three private resident rooms and one full common bathroom. The private resident room at the end of the hallway past the bathroom has an exit to the outside that leads to a private wood deck and a full private bathroom. In the back left corner of the first common area is a second common area with the sixth private resident room. Backyard was inspected. There is a wood deck that leads to the gate that is next to the garage. There is a locked shed on the side opposite the garage. Component III orientation was conducted.. This facility meets regulations. LPA is going to submit this report to the applications specialist.the state’s words, verbatim · CDSS document, Jul 12, 2021