Routine inspection·February 14, 2025

On 2/14/2025 at 11:00AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with caregiver, Catherine Ibanez and explained the purpose of the visit. Administrator, Marivel Calambro arrived 30 minutes later. The facility’s fire clearance was approved for 6 residents of which 4 residents maybe non-ambulatory and 2 residents maybe under hospice care. LPA toured the facility including but not limited to bedrooms, bathrooms, dining area, kitchen, garage, and outdoor area. Smoke and carbon monoxide detectors were observed. Fire extinguisher was observed to be full. One week of nonperishable and 2-day of perishable food supplies were available. LPA observed grab bars and non-skid mat in the bathrooms. There were adequate lights in each room. Resident rooms were observed to be cleaned. First Aid kit is complete. LPA reviewed 5 residents and 3 staff files starting at 11:30AM. At 12:15PM, LPA observed unlocked medications in the refrigerator. Staff locked up the medications during inspection. At 12:20PM, LPA observed unlocked knives and scissors in the kitchen. There was unlocked cleaning supplies in the bathroom and unlocked tools in the backyard. Staff locked up the items during inspection. At 12:25PM, LPA measured hot water temperature at 130.5 degrees F in the hallway bathroom. Staff lowered hot water temperature and LPA re-measured hot water at 118.1 degree F. At 12:45PM, LPA observed R1's physician's report dated 7/19/2024 states R1 has a dementia diagnosis which requires R1 to be in a non-ambulatory room. However, R1 is occupying room 5 which is ambulatory only. Civil penalty of $500 is being assessed. (continue on LIC809C...) At 1:00PM, LPA observed R1, R2, and R4 does not have TB test on file. At 1:10PM, LPA observed resident files were incomplete. At 2:00PM, LPA observed S3 does not have health screening and TB test on file. At 2:10PM, LPA observed S1, S2, and S3 does not have current first aid training on file. At 2:30PM, LPA observed facility did not conduct fire drill every three months. LPA will return at a later time to complete annual inspection. The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and Health & Safety Code. Failure to correct deficiencies may result in civil penalties. Exit interview conducted. A copy of this report, civil penalty, and appeal rights was provided.