Routine inspection·January 10, 2024

On 1/10/2024 at 2:05pm, Licensing Program Analyst (LPA) L. Hall conducted an unannounced 1-Year Required inspection. LPAs met with Caregiver Virginia Cada, caregiver, and explained the purpose of the visit. Administrator, Lelia Carbonel, arrived at 2:15pm. The Administrator currently holds a certificate (#6018225740) that expires on 09/19/2024. LPA toured the facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area and back yard. The facility consists of six (6) bedrooms and three (3) bathrooms. Staff occupies one (1) bedroom. All outdoor and indoor passageways are kept free of obstruction. LPA did not observe any bodies of water. A comfortable temperature is maintained at 73 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 103.8 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 01/08/2024. First aid kit was observed to be complete. Fire drill was last conducted on 12/16/2023. Continued on LIC809C. Continued from LIC809. Three (3) staff records were reviewed and all were complete. LPA reviewed all four (4) resident records and they were current and complete. LPA requested the following documents to be submitted to CCLD by 1/17/2024. LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan (last page) Liability Insurance Resident roster Exit interview conducted and a copy of this report provided.