Routine inspection·July 16, 2025

On 07/16/2025 at 12:35PM, Licensing Program Analyst (LPA) Carol Fowler conducted an unannounced 1-Year Required inspection. LPA met with Pamela Green, Administrator and explained the purpose of the visit. The facility’s fire clearance was approved for six (6) non-ambulatory residents. LPA toured the facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of four (4) total bedrooms which one (1) bedroom is occupied by staff, and two (2) bathrooms. No bodies of water observed. A comfortable temperature is maintained at 68 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 119.0 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 09/26/2024. First aid kit was observed to be complete. Continued on LIC809. Continued from LIC809. Three (3) residents' file were reviewed and are incomplete. LPA was informed by Administrator that there are no staff files available for review. LPA observed the following deficiencies: At 12:53pm, LPA observed unlocked laundry room door with chemicals such as awesome cleaner with bleach, laundry detergent and Lysol sanitizer. At 1:05pm, LPA observed unlocked pre poured medication sitting in the family room on a TV tray. At 1:10pm, LPA observed scissors, knives and tools such as screw drivers, box cutter. At 1:20pm, LPA observed during record review residents files incomplete. At 2:15pm, LPA was informed by Administrator that the facility dose not have staff files. At 2:47pm, LPA was informed by Administrator that the facility dose not have staff training's. At 3:22pm, LPA was informed by Administrator has not conducted a disaster drill in a while and has no record of drills conducted. LPA requested the following documents to be submitted to CCLD by 07/31/2025. Resident Roster LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan 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. Exit interview conducted. A copy of appeal rights and this report provided.