Glorious Home #3

Type of visit: Required - 1 Year

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of conducting the Required Annual Inspection. LPA was greeted and granted entry by facility caregiving staff after introducing himself and stating the purpose of the inspection. Administrator Jeena Sharma was also present and able to assist with the visit. The facility is currently undergoing a change of ownership with a pending application that was submitted in the days prior to the present annual. No pending license number has been provided at this time. During the inspection, LPA and administrator conducted a tour of the physical plant and observed the following: The facility is a one-story home with two private bedrooms, two shared bedrooms and two shared bathrooms in addition to the facility's common living areas. All resident bedrooms have the required furnishing, bathrooms are equipped with grab bars and slip mats. LPA observed all beds have linens and blankets. The backyard has a shaded area and the route of egress is free of clutter and obstructions. There are currently five residents admitted to the facility, two of which are currently receiving hospice care, with one of these pending discharge from hospice. Residents are observed to be clean and appear well taken care of. Various activities are observed to be provided over the course of the visit. Bathrooms faucets and toilets are operational. Water temperature was verified to be within the required range. LPA observed emergency disaster plan with means of exiting and emergency phone numbers listed and posted, however the facility is currently using form LIC610D which has been replaced by a new version, which was provided at the conclusion of the visit. Fire drills are conducted quarterly but are not being documented at this time. Smoke and carbon monoxide detectors tested operational. One fire extinguisher present is observed to be fully charged however maintenance is observed to have lapsed in April 2024. CONTINUED ON FORM LIC809-C CONTINUED FROM FROM LIC809 LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required. Sharp items, cleaning supplies and medications were confirmed to be inaccessible throughout the physical plant. The medication central storage was also observed to be secure and was reviewed for accuracy during the visit. During the review, one prescription for one of the admitted residents could not be found in the Medication Administration Records. Caregiving staff confirmed that the prescription was current and not discontinued (as verified on the container's label) and that the medication was currently being administered to the resident even though it had not been added to the records. LPA additionally reviewed five resident files along with five staff files. Some health screening forms and proof of CPR/First aid training were found to be either missing or outdated. Two admission agreements were found to be missing the previous administrator signature. Based on the observations made during today’s inspection, seven type B deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. LPA additionally provided a consultation on updates to the Infection Control Plan, Emergency and Disaster Plan as well as staff association requirements in Guardian. An exit interview was conducted, and a copy of this report along with appeal rights was left at the facility.the state’s words, verbatim · CDSS document, Aug 6, 2024

The state marks this report as 13 pages; the online copy we transcribed has 6. You can request the full file from the county licensing office.