Routine inspection·May 10, 2023

On this day, May 10, 2023, at 4:30 p.m., Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual required inspection. LPA met with staff, Joana Tiglao and Edwin Villarin. LPA called and spoke over the phone with Milanette Escueta, administrator. The administrator authorized Joana Tiglao to be with LPA during inspection, and to sign and receive this report. Facility has an approved LIC808 Mitigation Plan but has not submitted the current/updated LIC9282 Infection Control Plan. LPA inspected the facility inside and out including but not limited to living room. bedrooms, bathrooms, kitchen, dining area, garage, front, side and backyard. Facility has sufficient perishable and non-perishable foods. Fire extinguisher was observed fully charge with tag showed serviced March 15, 2023. Facility has carbon monoxide and smoke detectors that were tested, and observed functional. Hot water temperature in the common bathroom was tested, and measured at 109.1 degrees Fahrenheit. Facility conducts disaster drills, and records showed last conducted March 31, 2023. First aid kit inspected, and observed complete with manual. LPA observed the following: -at 4:59 m. collapsed boxes, toilet, mattress and bed frame in the backyard -at 5:00 pm. side fence leaning towards neighbor's side -at 5:30 pm, records showed Edwin Villarin fingerprinted and cleared but not associated to this facility. ......continued on 809C Administrator to submit the following current/updated documents by May 24, 2023: 1. LIC308 Designation of Facility Responsibility 2. LIC500 Personnel Report 3. LIC610E Emergency Disaster Plan (9 pages) 4. LIC9282 Infection Control Plan 5. Proof of $3M liability insurance. Due to time constraint, LPA will come back to continue inspection and review files. Deficiencies are cited from Title 22 California Code of Regulations and listed on 809D. Failure to submit proof of corrections (POCs) by plan of correction due dates, and any repeat violations within 12 month period may result in civil penalties. Deficiencies and plan and proof of corrections were discussed with Joana Tiglao. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.