Routine inspection·May 22, 2023

On 5/22/2023 at 2:10PM, Licensing Program Analyst (LPA) L. Hall conducted an unannounced 1-Year Required inspection. LPA met with Aurora Blancio, Administrator , and explained the purpose of the visit. The Administrator certificate is pending and expired 3/26/2023. The facility’s fire clearance was approved for six (6) non-ambulatory residents. LPA toured the facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of three (3) bedrooms and one and one-half (1-1/2) 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 113.0 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 06/20/2022. Emergency Disaster Plan was last posted on 06/22/2022. First aid kit was observed to be complete. Fire drill was last conducted on 01/5/2023. Continued on LIC809. Continued from LIC809. LPAs reviewed three (3) staff files. All three (3) staff did not have first aid or CPR. All four (4) residents' file were reviewed. LPA observed the following deficiencies: At 2:22PM, LPAs observed refrigerator/freezer and freezer in garage is unsanitary. At 2:25PM, LPAs observed a pair os scissors, allergy medication, a lighter, a bottle of Tylenol, and mucous medication in unlocked kitchen drawer. At 2:30PM, LPAs observed 4 cans of propane, a mattress, a bed frame, a shovel, and a drawer plastic bin in backyard passageway. At 2:45PM, LPAs observed during record review R2 and R4 do not have an current medical assessment. At 2:45PM, LPAs observed during record review none of the residents have a current appraisal needs and services plan. At 3:05PM, LPAs observed during record review none of the staff have first-aid or CPR training. LPA requested the following documents to be submitted to CCLD by 5/30/2023. 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 Continued on LIC809C. Continued from LIC809C. Deficiencies are cited from Title 22 California Code of Regulations (see 809D). Failure to submit proof of corrections by plan of correction due dates, and any repeat violations within 12-month period may result in civil penalties. Exit interview conducted. A copy of appeal rights and this report provided.