Routine inspection·June 24, 2025

On 6/24/2025, at 9:20am Regional Manager Stephenie Doub (RM) and Licensing Program Analyst Arvin Villanueva (LPA) arrived unannounced at this facility to conduct their required annual inspection visit. RM and LPA initially met with the staff on duty Licreisha Wilson (S1) and stated the purpose of this visit. The facility supervisor Renae Earl (S2) was notified and arrived shortly after. The Licensee Chukwudi (Patrick) Ikiseh was notified of the visit. Present during this visit were 4 residents in care with one staff on duty. Upon arrival, LPA observed 1 resident in the living room sitting on the sofa watching TV. One resident was at the dining table finishing their meal. Two other residents were in their bedrooms. RM and LPA evaluated the physical plant with S2 to ensure the health and safety of the residents in care. The facility is a one-story home located in a residential neighborhood. Areas inspected including but not limited to the kitchen, 5 resident bedrooms, 2 resident bathrooms, living and dining room and outdoor areas. LPA observed the inside of the facility to be clear of obstructions at this time. LPA inspected 5 of 5 resident bedrooms. Bedroom #4 in the facility sketch was observed to be unoccupied and per interview with S2, staff utilize this during the night. In bedroom #1, located by the kitchen area, RM and LPA observed a resident dresser and commode blocking the exit door to the outside. LPA measured the hot water temperature in 1 resident bathroom located in the hallway and was at 104 degrees Fahrenheit. Room temperature was observed at 77 degrees Fahrenheit. LPA observed sufficient seven day non-perishable and two day perishable food supplies. The fire door leading to the hallway where the resident bedrooms are located was observed to be propped open with a door stopper and it was observed to be in disrepair as evidenced by the door closer detached from the wall (photo was taken). {1 of 2} Fire extinguisher located in the kitchen was observed and were last inspected on 6/13/2025. Smoke and carbon monoxide detectors were observed and found to be working during this visit. LPA observed centrally stored medications, toxins, and sharp objects were kept locked and inaccessible to residents in care, except for the anti-diarrhea medication that was found in a kitchen drawer. S2 immediately took away the medication upon observation. Facility does not have a fireplace. During an inspection of the garage with S2, LPA observed futon beds to be propped up. Per interview with S2, staff no longer use this garage. Outdoor area was inspected. Facility has one exit gate. Pool was observed to be covered with deck flooring and was observed to be locked and not accessible at this time. There is a covered patio equipped with outdoor furniture. Facility is equipped with solar powered generator. Review of 4 resident files (R1, R2, R3 R4) include review of Admission Agreement, Physician Reports, Needs and Services Plan, Centrally Stored Medication Record and Ambulatory Status. Advisory was provided to ensure each resident have PRN authorization letter signed by their physician on file. Medication review was conducted for 2 of the residents (R3 and R4). No issues were noted at this time. Review of 3 staff files (S1, S2, and S3) include review of background clearance, First Aid/CPR certificate, Health Screen, Initial and Ongoing Training. Administrator Certificate is current. S1 did not have current First Aid certificate. Per interview with S2 confirms S1 did not complete their First Aid and S1 was observed to be working alone upon arrival. Facility conducts quarterly disaster drill. Facility has a dementia and infection control plan. Administrator to submit current Liability Insurance Certificate, LIC500 and LIC308 to the Department. Per the California Code of Regulations, Title 22, Division 6, Chapter 8, deficiencies were observed during today's visit. Exit interview was conducted and a copy of the report and appeal rights were provided upon exit. {2 of 2}