Routine inspection·February 5, 2025

On 2/05/2025 at 10:00 AM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced to continue the Required 1 Year Annual inspection. Upon arrival, LPA was greeted by Licensee/Administrator, Mona Eweda and 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. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 72 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 105.0 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week 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. Fire extinguisher was last serviced on 01/28/2025. Emergency Disaster Plan was last posted on 01/01/2025. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 1/1/2025. At 11:00am, LPA reviewed 4 residents records. At 10:00 am, LPA reviewed 3 staff records and 3 of 3 have current first aid training and associated to the facility. REPORT CONTINUES ON LIC 809-C THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: All staff are not up to date on training. Administrator does not hold a valid certificate and is not pending. R3 missing updated physicians statement as a dementia resident. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 3/05/2025: LIC 500 Personnel Report Updated Emergency Disaster Plan Current Administrator’s Certificate 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.