Routine inspection·January 2, 2025

On 01/02/2025 at 9:00 AM, Licensing Program Analysts (LPAs) P. Manalo and L. Fontanilla arrived unannounced to conduct 1-Year Annual Required inspection. LPAs met with Administrator, Jean Holt, and explained the purpose of the visit. Administrator certificate is current and expires on 05/12/2025. LPAs toured facility with inside and out including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 5 total bedrooms which 3 bedrooms are occupied by the residents and 2 bedrooms are occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 70 degrees Fahrenheit. LPAs 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 105 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last purchased on 04/16/2024. Emergency Disaster Plan was last posted on 01/02/2025. First aid kit was observed to be complete. Fire Drill drill was last conducted on 12/01/2024. At 9:16 AM, LPA reviewed 2 residents records. At 9:30 AM, LPA reviewed 2 staff records and 2 of 2 have current first aid training and associated to the facility. At 11:20 AM, LPA reviewed all of the resident’s medications. All records were observed to be complete and up to date. Continue to LIC 809-C... Continue from LIC809... Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 01/09/2025: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: At 9:20 AM, LPAs observed unlocked chemicals under the kitchen sink. At 9:23 AM, LPAs observed unlocked eye drops and insulin in the kitchen fridge. At 9:35 AM, LPAs observed the left side gate with a second sliding bolt. Civil penalty of $500 is being assessed. At 9:45 AM, LPAs observed unlocked medication in R1's closet. The Facility was cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties. Exit interview conducted. A copy of this report, civil penalty, and appeal rights was provided.