Routine inspection·February 25, 2025

On 02/25/2025 at 8:35 AM, Licensing Program Analysts (LPAs) P. Manalo and G. Luk arrived unannounced to conduct 1-Year Annual Required inspection. LPAs met with Senior Executive Director, Salvador Gomez, and explained the purpose of the visit. The facility’s fire clearance was approved for forty (40) non-ambulatory and 3 hospice waiver. LPAs toured the facility with Executive Director inside and out including but not limited to 6 residents' apartments, bathrooms, activity room, beauty salon, garden room, kitchen, common area and courtyard. LPAs observe lighting in all rooms are adequate for the comfort and safety of the residents. Two of Residents' temperature was maintained at 74 and 68 degrees Fahrenheit. The hot water temperature in a sample of residents’ room were measured at 115.9, 118.6, 115.3, 113.6 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid shower pan. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medications, sharps and toxic are locked and inaccessible to residents in care. Smoke detectors was last inspected on 01/10/2025. Carbon monoxide was in operating condition. Fire extinguisher was last serviced on 01/03/2025 all around the facility and in the kitchen. Emergency Disaster Plan was last posted on 02/25/2025. Emergency disaster drill was last conducted on 12/26/2024. Fire Drill was last conducted 01/30/2025. First aid kit was observed to be complete. At 10:08 AM, LPAs reviewed 5 residents records. At 10:38 AM, LPAs reviewed 5 staff records and are associated to the facility. At 1:20 PM, LPAs reviewed a sample of resident’s medications. Continue to LIC809-C... Continue from LIC809... Updated copies of the following documents were requested for facility file and are to be submitted to CCLD by 03/05/2025: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: At 11:25 AM, LPAs observed during file review that S2 to S5 does not have First Aid Certificate. At 12:00 PM, LPAs observed during file review that staff did not have documentation of training. 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 with Administrator. Appeal Rights and a copy of this report provided.