Routine inspection·October 2, 2024

On 10/2/2024 at 11:30am, Licensing Program Analyst (LPA) L. Hall conducted an unannounced annual required inspection. LPA met with Levi Villareal, Administrator, and explained the purpose of the visit. Facility does not have any residents at this time. LPA toured the facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of four (4) bedrooms and two (2) bathrooms. No bodies of water was observed. A comfortable temperature is maintained at 76 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 108.2 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars. There is a minimum of 7-day supply of non-perishable and 2-day of perishable foods. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 08/29/2023. First aid kit was observed to be complete. The following deficiencies were observed: LPA observed facility does not have liability insurance. Continued on LIC809C. Continued from LIC809. LPA observed there were not facility records to review. LPA requested the following documents to be submitted to CCLD by 10/8/2024. LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan (9 pages) Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC809D. Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. A copy of the appeal rights and this report provided.