Routine inspection·December 16, 2023

On 12/16/2023 at 9:11am, Licensing Program Analyst (LPA) Carol Fowler conducted an unannounced 1-Year Required inspection. LPA met with Genoveva Torres, and Eloisa Guevara Caregivers, and explained the purpose of the visit. The Administrator currently holds a certificate (#6010517740) that expires on 02/10/2024. The facility’s fire clearance was approved for six (6) non-ambulatory residents. LPA toured the facility with Caregiver including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of five (5) total bedrooms which one (1) bedroom is occupied by staff. No bodies of water observed. A comfortable temperature is maintained at 73 degrees Fahrenheit. 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 120.0 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 11/6/2023. First aid kit was observed to be complete. LPA reviewed four (4) of four residents files and four (4) of four (4) staff files, which were all complete. Continued on LIC809C. Continued from LIC809. LPA observed the following deficiencies: · At 11:45am, LPA observed pre-poured medication. LPA requested the following documents to be submitted to CCLD by 12/27/2023. · Resident Roster · LIC 308 Designation of Administrative Responsibility · LIC 309 Administrative Organization · LIC 500 Personnel Report · LIC 610E Emergency Disaster Plan (9 pages) · Liability Insurance Last Disaster Drill Conducted Document Based on LPA observations and interview, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 6, Chapter 8), are being cited on the attached LIC 9099D. Exit interview conducted and a copy of this report and appeal rights provided