Routine inspection·August 24, 2023

On 8/24/2023 at 3:30PM, Licensing Program Analysts (LPAs) L. Alexander and L. Hall conducted an unannounced 1-Year Required inspection. LPAs met with Elena Asuncion, Caregiver, and explained the purpose of the visit. Beth Quintong, Administrator, arrived at 5:00 PM. The Administrator certificate #6033318740 and expires 12/21/2024. 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 six (6) bedrooms and three (3) bathrooms. One (1) of the bedrooms is used by staff. No bodies of water was observed. A comfortable temperature is maintained at 75 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 105.7 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 08/4/2022. Emergency Disaster Plan was last posted on 11/1/2020. First aid kit was observed to be complete. Fire drill was last conducted on 07/24/2022. Continued on LIC809. Continued from LIC809. LPAs reviewed all five (5) resident files and all were in complete. Staff files was not available at facility for review at the time of arrival. Administrator brought staff files with her. LPA observed the following deficiencies: At 3:47PM, LPAs observed medicine cabinet unlocked. At 3:50PM, LPAs observed cabinet underneath kitchen sink with lock, but Lysol, Ajax, and other disinfectants were accessible to residents. At 3:55PM, LPAs observed facility did not have a seven (7) day of non-perishable and two (2) day of perishable foods available for residents. LPA observed 6 oranges, 2-gallons of milk, no can meat and only 1 can vegetable. At 3:55PM, LPAs observed medication in refrigerator unlocked At 4:00PM, LPAs observed during record review all residents files were incomplete. At 4:20PM, LPAs observed during record review none of the staff files were available for review at facility. LPA requested the following documents to be submitted to CCLD by 8/31/2023. 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 LIC9282 (Infection Control Plan) 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.