Routine inspection·April 9, 2025

On 4/9/2025 at 1:05 PM, Licensing Program Analyst (LPA) Carol Fowler arrived unannounced to conduct Required 1 Year Annual inspection. LPA met with staff Arthur Panelo, Administrator. LPA explained the purpose of the visit. The facility’s fire clearance was approved for 6 Non ambulatory. LPA toured facility with Administrator 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. 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 . 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. Smoke detectors and carbon monoxide detector were in operating condition during visit. LPA observed a purchased extinguisher with receipt attached dated 5/14/2024. First aid kit was observed to be complete. LPA reviewed 4 residents records. LPA reviewed 3 staff records all 3 have current first aid training and associated to the facility. LPA reviewed a sample of resident’s medications. Report continues on 809 C continue from LIC 809 Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 4/24/2025: 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- 1:27pm LPA observed medication (ketoconazole 2%) in R1's night stand drawer. At- 1:31pm LPA observed a weekly pre-poured medication organizer with medications located in the locked medication cabinet. At- 1:38pm LPA observed a lighter, scissors, medication loperamide Hydrochloride, Alaway eye drops and a screw driver. all located in the kitchen in a desk drawer. At- 1:42pm LPA observed an unlocked garage with unlocked Tide, WD40, Wind Fresh laundry, Lysol, Pine Sol, and other chemicals a tool box with tools and lighters. At- 1:46pm LPA observed a garbage can, fire extinguisher, commode, shower chair, mattress, foam mattress pad, Dolly, bed rail, all located in the side and back yard. 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.