Routine inspection·April 3, 2024

LPA Carol Fowler attempted to conduct an unannounced annual visit on 1/13/2024 at 9:30am. LPA arrived at the home, tried to enter the front yard but the gate was locked. There was no car located in the driveway. LPA attempted to call the facility there was no answer, LPA then attempted to call the Licensee (mobile number) but call went straight to voicemail, LPA left a message on both phone lines. LPA Carol Fowler made a 2nd attempt to conduct an unannounced annual visit on 1/13/2024 at 2:30pm. The gate at the facility was still locked. LPA will arrive at a later date to conduct an annual required visit. On 04/3/2024 at 1:30 PM, Licensing Program Analyst (LPA) Carol Fowler arrived announced to conduct a 1 Year Annual Inspection, LPA was greeted by the Administrator, Eufrocina Zaragosa (ADM) and explained the purpose of the visit. The facility is in disrepair (leaking pipes, buckling floors, Bosch Security Alarm System issues) there are no residents at the facility. Administrator will make corrections/renovations to the facility before accepting any residents. Administrator will reach out to the Department (LPA) Analyst as soon as the renovations are complete. LPA toured the facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area, and backyard. The facility consists of five (5) total bedrooms, and three (3) bathrooms. No bodies of water observed. A comfortable temperature is maintained. Continue on LIC809C Continue from LIC 809 LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 112.5 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars. Smoke detectors was in operating condition during visit. Fire extinguisher was last serviced on 03/25/2022. Emergency Disaster Plan was not posted. First aid kit was observed to be complete. The following forms are to be updated and submitted to CCLD once operation resumes -LIC500 Personnel Report -LIC308 Designation of Administrative Responsibility -LIC610E Emergency Disaster Plan -An updated copy of Administrator Certificate(s) Exit interview conducted and a copy of this report provided.