Routine inspection·March 12, 2024

On 3/12/2024 at 10:00AM Licensing Program Analyst (LPA) A. Gomez arrived unannounced to conduct a 1-Year Annual Required visit and met with Administrator, Erlinda Gines . The facility is cleared for all may be non-ambulatory. LPA toured and inspected the facility inside and outside with administrator including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of seven (7) total bedrooms which four (4) bedrooms are currently occupied by the residents and one (1) bedroom is occupied by staff. The facility has auditory signals on each sliding door in the resident's room. All outdoor and indoor passageways are kept free of obstruction. There were no bodies of water present at this facility. LPA observed medication located in Kitchen and were observed to be locked. LPA observed lighting in all rooms are adequate for the comfort and safety of the clients. A comfortable temperature is maintained at 70 degrees Fahrenheit. Hot water temperature in the residents’ shared bathroom was measured at 113.3 degrees F. Resident's bathrooms have grab bars inside the shower. The showers have non-skid mat. Hygiene items, extra linens and toiletry supplies were checked and sufficient. Fire extinguisher in kitchen was last serviced on 4/18/2023, smoke detectors and carbon monoxide were operational. First aid kit was inspected and was complete. Food supplies were sufficient to meet 2-day perishable and 7-day non-perishable requirements. 4 of 4 Resident records were reviewed at approximately 10:15AM. 3 of 3 Staff records were reviewed at approximately 10:36 AM. All staff were fingerprinted and associated to the facility. All staff have current CPR First aid certifications. First Aid kit was observed complete. Emergency disaster plan last reviewed 3/11/2024. report continues on LIC809-C The Following Deficiencies were Observed At 10:50 during file review LPA observed and found out through conversation with administrator that there is not adequate staffing for the needs of residents as R4 can require a 2 person assist Updated copies of the following documents were requested for facility file and are to be submitted to CCLD by 03/31/2024: LIC 500 Personnel Report LIC 308 Designation of Administrative Responsibility LIC 610E Emergency Disaster Plan The following 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. Appeal Rights and a copy of this report provided.