Routine inspection·April 19, 2023

On 4/19/2023 at 9:30 AM, Licensing Program Analyst (LPA) P. Watson arrived unannounced to conduct Required 1 Year Annual inspection. LPA met with Administrator, Arthur Panelo and explained the purpose of the visit. The facility’s fire clearance was approved for 6 Non ambulatory. LPA toured facility with Jovito including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 7 total bedrooms which 6 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 70 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 119 degrees Fahrenheit. Residents’ bathroom is equipped with grab bars and non-skid mats. There is a minimum of 7 day supply of nonperishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detector were in operating condition during visit. LPA observed a purchased extinguisher but did not see a receipt attached. Administrator stated that they last purchased the fire extinguisher around 3 years ago. First aid kit was observed to be complete. Report continues on 809 C At 9:50 AM, LPA reviewed 5 residents records. At 10:15 AM, LPA reviewed 4 staff records and 4 of 4 have current first aid training and associated to the facility. At 11:40 AM, LPA reviewed a sample of resident’s medications Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 5/17/2023: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Current Administrator’s Certificate The following deficiencies were observed: -At approximately 10:45 AM LPA observed a purchased fire extinguisher without a receipt. Administrator stated they made the purchase approximately 3 years ago and will purchase a new one. The following deficiencies were observed (see LIC 809 D) and cited from the California Code of Regulations, Title 22 and 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.