Partners in Senior Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jacqueline Shaw Ross made an unannounced visit to the facility for the purpose of an annual review. LPA met with Brenna Tomlinson, Administrator and explained the purpose of the visit. A tour of the facility was conducted inside and out. At the time of visit, there were six (6) residents home and one (1) staff present. The facility is a six (6) bedroom four (4) bathroom one story home. Each resident has a private room. During the tour the following was observed: Residents bedrooms had the required furnishings and were observed to be in good condition. Bathrooms had required hand rails, non-slip mats, hand washing signage and personal toiletries. Night-lights were observed in the hallways. Fixtures and furniture for an operational facility are present and in good repair. All passageways were free of obstructions, charged fire extinguishers and the fire alarm system was operable, medications are kept centralized and locked, hazardous items are kept inaccessible clients. Hot water was tested at 15.7 degrees Fahrenheit. Backyard area is free from obstructions. Kitchen/Food Service: LPA observed the entire kitchen, food is stored properly and dishes are clean and in good condition. There is a sufficient supply of perishable and non-perishable foods. LPA observed fresh fruit and vegetables in the refrigerator. During the inspection of the kitchen and dining area, LPA observed ants and cockroaches in some of the kitchen cabinets and on the dining room floor. Administrator stated the facility has been receiving pest control services specifically for the above mentioned pests since September 2023. LPA was also informed that the facility has been receiving pest control services in general since March of 2022. LPA was provided the last six month copies of invoices from a pest control service. Continue on LIC 809C.... Care & Supervision: Facility has sufficient care staff employed. LPA interviewed one staff member. Administration: Emergency exiting plans, telephone numbers and Ombudsman information and other required signage are posted throughout the facility. Drills are conducted monthly. The last drill was conducted in August 2023. The Administrator's certificate expires on 9/22/2024. Record Review and Client/Staff Files: LPA reviewed current staff and all staff have has Criminal Background Clearance, current CPR/First Aid certification, and trainings are current. Upon review of client records, the following deficiency was observed: -LPA observed three out of six resident resident files reviewed did not have current Physician Reports. Medication Review: LPA reviewed medication and medication log. Residents' medications are being dispensed according to physician's orders however upon audit of medications the following deficiency was observed: -LPA observed medications for all clients were prepared in advanced and stored in medication cups. LPA informed Administrator this was against regulations. Deficiencies were cited in the above references. A copy of this report along with LIC 809D, LIC 811 and Appeals Rights were provided to Administrator Brenna Tomlinson.the state’s words, verbatim · CDSS document, Oct 10, 2023

Type of visit: Prelicensing

Licensing Program Analyst (LPA), Stephanie Torres, conducted an announced pre-licensing inspection to the facility. The LPA met with Applicant, Brenna Tomlinson. Application: The application is for a Residential Care Facility for the Elderly (RCFE). The fire clearance has been granted for six (6) non-ambulatory residents. A Hospice Waiver has been granted for two (2). Buildings and Grounds: The home is composed of six (6) resident bedrooms,a separate staff living quarters, five (5) bathrooms, two living room spaces, kitchen and dinning areas, a front/back yard area (with seating), and laundry room. The interior/exterior walkways of the home were observed to be clutter free with no obstructions present. Smoke and Carbon Monoxide detectors were tested and operable. There is no pool or other bodies of water located on the premises. According to Tomlinson, there are no weapons stored in the home. Rooms, furniture, beds, mattresses are all in good repair. The bedrooms are completely furnished and privacy is available. The dining and living room areas are clutter free and in good condition. Bathrooms were observed to have non-slip mats available. The hot water was tested and measured at 109.2 degrees Fahrenheit, which is within regulatory limits. Outdoor areas had sufficient room for activities and leisure. A washing machine and dryer are available and in working order. Storage and Supplies: Activities were observed to be available and in sufficient amount for the requested census. Medications will be stored inaccessible to any unauthorized individuals. Secured areas are available for facility files and resident files. The first aid kit was observed to be available and complete. Cleaning supplies will be stored away in a secured bin. Linens, towels, and other equipment are all in good repair and sufficient for approved census. A Fire extinguisher was available and fully charged. Food Service: Utensils and dishware are sufficient for the requested capacity. The refrigerator and stove are in working order. Sharps will be stored in a locked kitchen pantry, available only to authorized individuals. Forms: The following signs were observed to be available at the home: Emergency Disaster Plan (LIC 610E), Theft and Loss Policies, Visitors Policy, Personal Rights/Non Discrimination policy, and Facility Sketch (LIC 999), and Complaint Information. No follow ups are required at this time. The LPA will inform the Centralized Applications Bureau (CAB) the home is ready for licensure. This report was discussed with and a copy provided to Tomlinson.the state’s words, verbatim · CDSS document, Sep 28, 2022

Type of visit: Office

Component II completion: Successful Facility Type: Residential Care Facility for Elderly (RCFE) Application Type: Change in Ownership (CHOW) Capacity: 6 Census (if any clients in care): 5 COMP II Participants: Brenna Tomlinson, Administrator Interview Method: Telephone interview On September 8, 2022 at 10:10 AM, Administrator participated in COMP II. Identification of the Administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, Administrator confirmed the understanding of the California Code Title 22 Regulations. During COMP II, CAB analyst confirmed Administrator’s understanding of following areas: 1. Facility Operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing Requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General Provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing Readiness Exit interview conducted with Administrator. Report email PDF and informed Administrator to return sign copy by end of business day today.the state’s words, verbatim · CDSS document, Sep 8, 2022