Routine inspection·June 15, 2024

On 6/15/2024 at 11:25am, Licensing Program Analyst (LPA) L. Hall conducted an unannounced 1-Year Required inspection. LPA met with Rochelle Balancio, Caregiver, and explained the purpose of the visit. Administrator, Aurora Balancio, arrived at 11:55am. The Administrator certificate #7000305740 3/26/2025. 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 114.6 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non skid mats. 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 10/23/2023. Emergency Disaster Plan was last posted on 06/22/2022. First aid kit was observed to be complete. Fire drill was last conducted on 03/4/2024. Continued on LIC809. Continued from LIC809. LPA reviewed three (3) staff files. Two (2) of three (3) staff did not have first aid or CPR. All five (5) residents' file were reviewed, current, and complete. LPA observed the following deficiencies: At 12:00pm, LPA observed during record review S1 and S3 did not have first aid or CPR certification. LPA requested the following documents to be submitted to CCLD by 5/24/2024. LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan (Last page) Liability Insurance Deficiency is cited from Title 22 California Code of Regulations (see 809D). Failure to submit proof of corrections by plan of correction due date, 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.