Heritage Place

On 07/18/2024, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced annual inspection visit. LPA met with administrator Villarose Gratuito then later the co-licensee Thomas Eisman arrived and LPA met with him as well. LPA was allowed entry into the facility. This is a single level facility approved all residents to be non-amblatory and 6 hospice residents. The physical plant was toured inside and outside of the facility to ensure the safety of the residents. LPA observed the facility kitchen which is clean and observed appliances are in good repair. Knives are stored and locked in the kitchen in a drawer adjacent to the facility stove. Medications are observed to be locked in a cabinet adjacent to the refrigerator. Perishable and non-perishable food items are observed as in place. There are additional refrigerator and freezer in the garage area which also carry additional food supplies. First aid kit is observed as complete with required items. LPA observed that there are multiple fire extinguishers in place inspected 06/21/2023, smoke detector, carbon monoxide detectors are observed in place through out the facility, and central heating/cooling system. The facility has fire sprinkler system through out the facility. PPE and additional food supplies are observed as in place. Laundry area is also observed as fully operational. Emergency exit routes are observed inside and outside to be free and clear of obstructions. Last emergency/disaster drill was conducted on 01/08/202 which can pose a potential health and safety risks for residents and staff in care. Per administrator they have conducted additional drills but the documentation does not reflect this from happening. Water temperature was measured at 130F in a common resident bathroom in the hallway connecting to resident rooms. This temperature poses an immediate health and safety risk to residents in care. Continued on next page... 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Page 2 LPA observed rooms numerous resident rooms and all appeared clean, free of odors, and contained all the required furniture per regulatory recommendations. All resident rooms are equipped with half baths. Resident linen supplies are observed as in place. Cleaning supplies are also observed as locked inaccessible to residents in care. There is a staff room connected to the living room. Facility does not handle resident monies. The following updated forms are requested to be submitted to CCLD by 07/25/2024 : • Copy of updated Administrator Certificates • Copy of facility's liability insurance • LIC308 Designation of responsible staff person • LIC400 Affidavit Regarding Client/Resident Cash Resources • LIC610E Emergency Disaster Plan • LIC500 Staff Schedule • Copy of control of property Citation issued on this day on the attached LIC809D. Report is reviewed with the administrator and a copy is provided on this day.

On September 8, 2022, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual infection control inspection. Upon arrival, LPA observed the COVID-19 signage posted at the front door. LPA met with a staff member (S1), and Administrator, Villarose Gratuito joined shortly thereafter. LPA explained the purpose of the visit. Administrator was able to provide LPA was screening log documentation for staff, residents and visitors. LPA toured facility and grounds. No accessible bodies of water or fire safety hazards observed. Infection control practices are present: entry procedures, and daily monitoring for residents and staff. LPA observed the COVID signage posted throughout the facility. This is a single story with 9 bedrooms (3 shared rooms and 6 private rooms), 4 half-bathrooms, 1 shower room, and 2 full bathrooms. LPA observed all bathrooms in the facility and advised Administrator to throw all bar soaps away and ensure bathrooms are equipped with liquid soap. In addition, LPA did not observe any hand-towels and there were no lids on the trash cans. Hand-washing signage was observed in bathrooms. LPA toured all resident rooms and observed the 3 shared rooms to have beds 6ft apart from each other. LPA toured the kitchen and advised Administrator to switch out hand-towels for paper-towels and disinfectant wipes. LPA observed 2 day perishable and 7 day non-perishable. LPA observed sharps drawer to be unlocked and accessible to residents. LPA toured the garage and observed extra food supply. LPA observed the medications locked an inaccessible to residents. First aid kits was observed to be completed. Washer and dryer in laundry room were in good repair. Cabinet with chemicals was observed to be unlocked and accessible to residents. CONT. to 809C 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Shower room was observed. According to the Administrator, no residents use the shower room. The living room was clear from any tripping hazards. A comfortable temperate at 81 degrees F was maintained. Lighting was sufficient for comfort. It was found during the visit that S1 was not fingerprint cleared and associated to the facility. According to the Administrator, she sent the fingerprint transfer documents to the Licensee, however the Licensee failed to associate S1 prior to working at the facility. This violation results in a civil penalty of $100 per day x 2 days = $200.00 Deficiency of the Residential Care Elderly California Code of Regulations, Title 22, Division 6 is observed and cited on a LIC 809D. Failure to correct the deficiencies may result in civil penalties. Report is reviewed with Administrator and a copy is provided with appeals rights. Civil Penalty is also assessed and given during the visit.