Kimochi Home

On 5/30/2025, Licensing Program Analyst (LPA) Tobola conducted an unannounced Annual Required – 1 yr. inspection for this facility and was greeted by Executive Director, Linda Ishii. The facility currently provides care for 14 residents some of which with a diagnosis of dementia. LPA continued with a tour of the facility with staff, facility found to be clean and at a comfortable temperature with all exits free from obstruction. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguishers located throughout the facility were found to be charged. Smoke and carbon monoxide detectors were present. Emergency disaster plan is reviewed and completed. Disaster drills are conducted on a quarterly basis and documented. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations, with food stored in the kitchen refrigerator found to have appropriate coverings, enough for residents in care. There was a supply of hygiene products and paper products available for residents. Resident's bedroom have lighting & appropriate furnishings and bedding items. Restrooms for resident use were equipped with non-slip mats, grab bars and kept in good condition. There is a large outdoor patio equipped with appropriate shading for resident use. Medications are stored in staff office and found to be secured. Upon spot review of medications, LPA found that the facility has centrally store medication records updated and in order. LPA conducted a sample file review for residents and found all items to be current. Upon a sample review of staff files LPA found that all caregiver staff have current 1st aid and CPR certification and health screening on file. The facility is also on track for completing staff annual training. LPA requested the following documents be sent to CCL by COB 6/13/2025: LIC 308 Designated Facility Responsibility LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan No deficiencies cited

On 8/20/2024, Licensing Program Analyst (LPA) Tobola arrived unannounced for the purpose of conducting a case management, following up on facility incident report. An incident occurring on 8/17/2024 involving resident (R1) leaving the facility unassisted. LPA toured the facility and interviewed Director of Residential Services, Linda Ishii. Based on interview, R1 had not previously demonstrated this behavior or desire to leave the facility site. The facility contacted appropriate parties including local police department and R1's POA and submitted an incident report to CLLD. R1 had been located at the local medical center in close proximity to the facility. R1 was assessed and found no signs of injury or changes of condition and safely returned. Based upon a review of R1's records, it was found that R1 is cleared by their physician to leave the facility unassisted and does not have a diagnosis of dementia. LPA and Administrator discussed several items following the incident, including supervision and reassessments for R1, in order to prevent further incidents from occurring. Facility to provide LPA with copies of R1's updated records once completed. In addition, LPA and Director of Residential Services discussed request for Fire Clearance Inspection. LPA was provided request documentation. Facility to provide updated facility sketch prior to LPA submitting inspection request to local fire department. No deficiencies cited during today's visit.

Licensing Program Analyst (LPA) Murial Han and Chief Deputy Director, Claire Ramsey conducted an unannounced annual required inspection. LPA met with staff, Sandy Ishii. At 9:30 am LPA and Chief Deputy Director arrived at the facility and were greeted by staff. LPA observed COVID-19 signs posted at the facility entrance. LPA and Chief Deputy Director were properly screened and toured the facility beginning in the front entrance where COVID-19 signs are posted. The water fountains on the 1st and the 2nd floor are block off by blue tapes with a sign stating, " Do not use; out of order" to ensure no one is using them. The dinning room has 4 long tables and the chairs that are spaced to promote social distancing. COVID-19 Infection Control signs are posted throughout the facility both in English and Japanese. There are signs in the elevator for social distancing and reminder no more than 2 people at the same time. There were residents watching TV on the 1st floor with social distancing and some were wearing face covering. The sofas on the 2nd floor Activity Room are marked with blue tapes to ensure social distancing is maintained. Hand washing stations were equipped with paper supplies and soaps and hand hygiene signs are posted around the faucets. The garbage cans are observed to be closed lids. The facility has designated an isolation room on the 2nd floor with an isolation cart set-up. PPE supplies are stored in the isolation cart on the 2nd floor, by the front entrance and in the staff break room. The bed rooms were observed to be furnished per Title 22 regulations. Beds were spaced at least 6 feet apart. Medications are stored appropriately and inaccessible to resident, a comfortable temperature is maintained, lighting is sufficient for comfort and safety, food supply was checked and observed to be sufficient. First-aid kit is inspected and complete. During today's inspection, LPA and Chief Deputy Director reviewed facility's daily COVID-19 screening logs for residents, staff and visitors. The facility will submit the following documents by 6/28/2022: LIC309, LIC308, LIC400, Administrator Certification, and LIC610E No deficiency was cited today. This report was discussed and reviewed with staff. A copy was provided during visit.