Routine inspection·November 21, 2023

On 11/21/2023 at 1:10pm, Licensing Program Analyst (LPA) L. Hall conducted an unannounced 1-Year Required inspection. LPA met with Noupane Temple, Administrator , and explained the purpose of the visit. LPA toured the facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of five (5) bedrooms and three (3) bathrooms. No bodies of water was observed. A comfortable temperature is maintained at 69 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 128.3 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 09/13/2023. First aid kit was observed to be complete. LPA reviewed three (3) staff files and two (2) files were incomplete, and all three (3) staff was not first aid or CPR certified. LPA also reviewed the resident file and it was current and complete. Continued on LIC809. Continued from LIC809. LPA observed the following deficiencies: At 1:35pm, LPA observed unlocked cabinet containing medication. At 1:50pm, LPA observed shovels, pressure washer, freezer, and a mattress in back yard. At 2:00pm, LPA during record review staff files were incomplete. At 2:05pm, LPA observed none of the staff were first aid or CPR certified. LPA requested the following documents to be submitted to CCLD by 12/04/2023. 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 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.