Routine inspection·July 18, 2024

Licensing Program Analyst (LPA) Carol Fowler conducted an unannounced 1-year required visit on 7/18/2024 at 9:50am. LPA met and toured with Caregiver, Maria Theresa. Administrator, Alex Juntilla arrived at 11:20am. The Administrator currently holds a certificate (#6020375740) that expires on 11/17/2024. The facility’s fire clearance was approved for 6 non-ambulatory residents. LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 6 total bedrooms which 2 bedrooms are occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. LPA observed lighting in all rooms are adequate for the comfort and safety of the clients. Hot water temperature in the shared residents bathroom was measured at 110.7 degree Fahrenheit. All toilets, hand washing, and bathing are safe, sanitary and in operating condition. The supply of extra hygiene was available for residents. There is a minimum of 7-day non-perishables and 2-day perishables foods. Smoke detector were not in operating condition, Carbon monoxide detector was in operating condition. Fire extinguishers were last serviced on 10/22/2023. Emergency Disaster Plan was last posted on 10/22/2023. First aid kit was observed to be complete. LPA reviewed 4 staff files. All files were incomplete . LPA reviewed 5 resident files and all were found to be incomplete. Report continues on 809C. CONTINUE FROM LIC 809 LPAs observed the following deficiencies: - at 10:25am. LPA observed Comet, Purell Cleaner, Fabuloso. - at 10:35am. LPA observed medication in an unlocked drawer located in the kitchen. - at 10:40am. LPA observed door frame and side of dishwasher in disrepair. - at 10:45am, LPA observed smoke detector not working. -at 10:48am, LPA observed staff has expired CPR/First Aid training. -at 10:50am, LPA observed residents files incomplete. -at 10:53am, LPA observed facility has not conducted a fire/emergency disaster drill. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct deficiencies may result in civil penalties. The following forms to be updated and submitted to CCL by 07/25/2024: LIC 500 Personnel Report LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 610E Emergency Disaster Plan Exit interview conducted. Appeal Rights and a copy of this report provided.