Routine inspection·December 6, 2023

On 12/06/2023 at 9:30am, Licensing Program Analyst (LPA) C. Fowler conducted an unannounced 1-Year Required inspection. LPA met with Priscilla Tapia, Caregiver, and explained the purpose of the visit. The Administrator Mia Enriquez arrived at approximately 11:15am. The Administrator currently holds an expired certificate (#6009401740) that expired on 12/01/2023, Administrator provided a copy of documents (education and application) mail for renewal. The facility’s fire clearance was approved for six (6) non-ambulatory residents. LPA toured the facility with Caregiver including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of four (4) total bedrooms, and two (2) bathrooms. 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 123.8 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and nonskid mats. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 04/28/2023. Emergency Disaster Plan was last reviewed and updated was 05/05/2023. First aid kit was observed to be complete. Continued on LIC809C. Continued from LIC809. LPA observed the following deficiencies: · At 10:36am, LPA observed water temperature measured at 123.8. · At 10:40am, LPA observed a commode, 2 mattresses, bed rails, screen doors and soil, brooms, plants, in a chair located in the back yard. · At 10:46am, LPA observed facility had a bedroom in the garage that is not fire cleared. LPA requested the following documents to be submitted to CCLD by 12/20/2023. · 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 The deficiencies were observed (see LIC809D) and cited from the California Code of Regulation, Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. *An immediate $500.00 civil penalty will be assessed on today's date for associations.* Exit interview conducted. A copy of the LIC421IM, this report and appeal rights provided