Routine inspection·February 10, 2025

On 2/10/2025 at 9:20 AM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Ana Breen and explained the purpose of the visit. The facility’s fire clearance was approved for all residents may be non-ambulatory. LPA toured facility with Ana Breen including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 6 total bedrooms which 1 bedrooms are occupied by the residents and 3 bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. Pool observed locked and secured. A comfortable temperature is maintained at 68 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 110.8 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 serviced on 11/19/2024. Emergency Disaster Plan was last posted on 02/10/2025. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 01/15/2025. At 11am, LPA reviewed 1 residents records. At 11:30 am, LPA reviewed 2 staff records and 2 of 2 have current first aid training and associated to the facility. At 1:00pm, LPA reviewed a sample of resident’s medications. Report Continues on LIC809-C THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: LPA observed that the facility is cluttered and not sanitary; dust throughout LPA observed a pair of green scissors unlocked LPA observed expired food in the refrigerator and not stored properly; expired broccoli and uncovered open food. LPA observed unlocked medications in the refrigerator ***Civil Penalties issued for repeat violations 3 X $250 *** Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 03/03/2025: LIC 500 Personnel Report Current Administrator’s Certificate The following deficiencies were observed (see LIC 809D) and 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. Appeal Rights and a copy of this report provided.