Routine inspection·January 6, 2023

On 01/06/23 at 10:17AM, Licensing Program Analyst (LPA) L. Alexander and Licensing Program Manager (LPM) J. Fong arrived unannounced to conduct 1-Year Annual Required inspection. LPA and LPM met with Administrators, Keith Mauer and Stephanie Salas Mauer and explained the purpose of the visit. LPA toured facility with Keith and Stephanie including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of total 6 bedrooms which 4 bedrooms are occupied by the residents and 1 bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 76 degrees Fahrenheit. LPA and LPM 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 125.2 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. Centrally stored medication and sharps were locked and inaccessible to residents. Fire extinguisher was last serviced on 09/15/2020. First aid kit was observed to be complete. The following deficiencies were observed: - Paint was accessible in the backyard - Vitamins for a former resident were observed by LPA and LPM accessible in the kitchen. - Fire extinguisher was last checked over 12 months ago. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 09/13/2023: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Facility Sketch Liability Insurance Current Administrator’s Certificate Monkeypox Mitigation Plan The 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 and a copy of this report and appeal rights were provided.