Serrano Manor

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Lavinia Muscan arrived on 8/3/23 to conduct the annual inspection. During today's annual inspection, the Compliance and Regulatory Enforcement Tool was used. LPA reviewed resident (2) and staff files (1). All resident files contained the required paperwork. Staff file contained the required paperwork. Staff has 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 Caregiver Olga Zhmurko 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. Exit interview conducted. A copy of this report was printed and given to Caregiver.the state’s words, verbatim · CDSS document, Aug 3, 2023

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kerry Hiratsuka arrived at the facility unannounced to conduct a Annual Visit. LPA conducted COVID-19 Precautionary prescreening, and wore a surgical mask while at facility. LPA was screened by Caregiver. LPA and Caregiver toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, resident bedrooms, and common restrooms. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA and Caregiver completed the infection control domain and facility was found to be in substantial compliance at this time. Multiple topics were discussed. 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, Sep 8, 2022

Type of visit: POC

Plan of correction visit to clear the deficiency from the 9/20/21 case management - deficiencies visit. The sole deficiency from that visit has been cleared. There are no outstanding deficiencies at this time.the state’s words, verbatim · CDSS document, Sep 29, 2021

Type of visit: Required - 1 Year

Note - This annual required visit initially occurred on 9/10/21 from 1100 - 1300. Due to laptop malfunction the entire 2 hour visit was lost and could not be recovered bt FAS specialists. Findings from that visit are being delivered today.the state’s words, verbatim · CDSS document, Sep 20, 2021

Type of visit: Case Management - Deficiencies

During the dropping off of facility documents, upon exiting the facility, LPA noticed four (4) deadbolt locks located on the front door. One deadbolt was approximately 6' 6" above the floor. In the event of an emergency it would be highly unlikely or impossible that the residents would be able to egress the facility in a timely manner due to the amount of locks and specifically the height which would place it out of reach of most clients. This is a violation of the fire clearance. See 809-D for deficiency cited. Civil penalties shall apply.the state’s words, verbatim · CDSS document, Sep 20, 2021

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87202(a) · Plan of correction due date: Sep 21, 2021

87202-Fire Clearance-All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal. This requirement is not met as evidenced by: Based on LPA observation, licensee did not maintain the fire clearance as there were 4 deadbolt locks on the front door including 1 which was approximately 6' 6" above the ground and another that is difficult to open requiring several movements to unlock. Residents will not be able to access this and the other deadbolt locks. This is in violation of this section. This poses an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Sep 20, 2021

Plan of correction: Facility shall remove all deadbolt locks except the one directly above the door handle, which is the original, one twist, deadnolt lock. This shall be done within 1 day. LPA will revisit facility to clear this deficiency.