Routine inspection·December 20, 2023

On 12/20/2023 at 12:30pm, Licensing Program Analysts (LPAs) L. Hall and T. Syess-Gibson, conducted an unannounced 1-Year Required inspection. LPAs met with Benita Deguzman, Caregiver and explained the purpose of the visit. Administrator, Cindy Chen, arrived at 12;53pm. The Administrator holds a certificate #6019228740 expires 8/29/2024. The facility’s fire clearance was approved for eight (5) non-ambulatory residents. LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and back yard. The facility consists of six (6) total bedrooms, two (2) bathrooms, and one (1) office. All outdoor and indoor passageways are kept free of obstruction. 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 117.5 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of 7-day supply of non-perishable and 2-day of perishable foods. Smoke detectors/ carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 12/20/2022. Emergency Disaster Plan was last posted on 7/28/2023. First aid kit was observed to be complete. Continued on LIC809. Continued from LIC809. Five (5) staff records were reviewed, and all staff have criminal record clearance. All seven (7) resident records were reviewed and none contained the appraisal needs and services plan. LPA observed the following deficiencies: At 1:00pm, LPAs observed during record review none of the resident files contained an appraisal needs and services plan. At 1:48pm, LPA observed vitamins, cough medicines, and other medication in unlocked kitchen cabinet. At 1:55pm, LPA observed a wrench, screwdriver, and 3 bottles of air fresher in unlocked cabinet located over washer and dryer. 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 the appeal rights and this report provided.