Mother Conching

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to conduct an annual inspection. LPA met with Administrator John Paul Pamintuan during today's inspection. LPA ensured they applied hand sanitizer before entering the facility. LPA toured facility with administrator to ensure health and safety of residents in care. LPA toured 6 resident rooms, 2 bathrooms, kitchen, common living spaces, backyard and the garage area. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA toured the backyard and all exits are accessible and unlocked. There is a locked storage for medications and toxins. Food supply is adequate for 2-day perishable and 7-day nonperishable. LPA observed an adequate amount of linens and found the first aid kit to be complete. LPA reviewed 2 of 3 resident files and 2 staff files. LPA reviewed medications of two residents comparing with Centrally Stored Medication Record and physician orders. A review of staff records indicates that all facility staff has received criminal record clearances and/or are associated to this facility. Staff records reviewed indicated current first aid certificates and training completed. No deficiencies are being cited as a result of todays inspection. Exit interview conducted.the state’s words, verbatim · CDSS document, Jul 18, 2023

Type of visit: Required - 1 Year

Licensing Program Analyst Talwinder Bains arrived at the facility unannounced on 07/13/2022 to conduct a Required-1 Year Inspection utilizing the infection control domain. LPA met with Administrator ,Marco Gomez and Co-Administrator John Paul Pamintuan (John) was also present during inspection. Prior to initiating the inspection, LPA explained the purpose of the visit. Prior to initiating the annual inspection, LPA completed required COVID-19 testing protocols, the daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPA confirmed that facility does not any covid-19 case and nobody showing any symptoms of covid-19 before facility entry. LPA wore the following Personal Protective Equipment (PPE) during today's visit: surgical mask. LPA was screened by facility staff before entry to facility. LPA and John toured facility together to ensure the health and safety of residents in care. Areas toured include but are not limited to: kitchen, common areas, 6 residents bedrooms , 3 bathrooms, medication closet , laundry area , garage and backyard. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA and John completed the infection control domain together and facility was found to be in substantial compliance at this time. No deficiencies are being cited as a result of today's inspection. Exit interview conducted and copy of report left at the facility.the state’s words, verbatim · CDSS document, Jul 13, 2022

Type of visit: Post Licensing

Post Licensing visit is conducted in 07/13/22 inspection. No deficiencies are cited. See 809 for Annual visit for 07/13/22 for details. Exit interview done and copy of the report left at facility.the state’s words, verbatim · CDSS document, Jul 13, 2022

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Praveen Singh arrived to conduct an announced Pre-Licensing inspection. LPA met with Administrator Marco Gomez and explained the purpose of the visit. Co-Administrator John Paul Pamintuan was also present during inspection. Prior to initiating the Pre-Licensing inspection, 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 she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. Additionally, LPA was screened by John Paul Pamintuan upon arrival. This Pre-Licensing is relative to facility's change of ownership. This facility currently has 3 residents and is operating under license number 317004917. LPA and administrator toured the facility and common areas, activity room, dining room, kitchen, backyard and resident rooms were inspected. Facility has six (6) private resident bedrooms, and three (3) resident bathrooms. Bathrooms were equipped with grab bars and non-skid mats and hot water temperature measured at 106.3 degrees F. Bedrooms were equipped with required furniture and smoke detectors and carbon monoxide detectors were present. Fire extinguisher was observed to be fully charged and last serviced on 2/11/21. Facility's fire clearance was granted on 7/6/21. LPA observed a sufficient 2-day supply of perishable and 7-day supply of non-perishable foods. LPA observed there are adequate amounts of linens, towels, and dishes at the facility. LPA observed locked cabinet for sharps, toxins, and centrally stored medications. First aid kit was found to be complete. LPA reviewed sample staff and resident files and found required forms to be in the files. Administrator stated that disaster drills will be completed and documented at minimum every three months. [See LIC809-C for Continued Report] LPA observed that facility is ready to be licensed. This report will be submitted to the Centralized Applications Bureau (CAB) and a final review of the application will be conducted. This facility is not yet licensed, and is subject to final approval by CAB. Additional requirements may still be required. Exit interview conducted and copy of report provided. [See LIC809 (Case Management Report) dated 7/29/21, for Comp III Review Conducted today]the state’s words, verbatim · CDSS document, Jul 29, 2021

Type of visit: Case Management - Other

While at the facility conducting a Pre-Licensing inspection, Licensing Program Analyst (LPA) Praveen Singh conducted a Component III Orientation with Applicant/Administrators Marco Gomez and John Paul Pamintuan During the inspection, Applicant/Administrator was provided with information to operate the facility within Title 22 regulatory compliance, as well as how to avoid common problem areas. Component III does not cover ALL regulations, only those found to be most problematic. Regulations require Administrator to be knowledgeable of all regulations and amendments to law. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Jul 29, 2021