Routine inspection·March 3, 2023

On 3/3/2023 at 2:30PM, Licensing Program Analyst (LPA) L. Hall conducted an unannounced 1-Year Required inspection. LPA met with Administrator, Marcelina Badeo and explained the purpose of the visit. The Administrator currently holds a certificate (#6035565740) that expires on 06/23/2023. 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 and back yard. The facility consists of eight (8) total bedrooms which six (6) bedrooms are occupied by the residents and two (2) bedrooms are occupied by staff. All outdoor and indoor passageways are kept free of obstruction. LPA observed pool in the back yard is inside a locked fence. 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 110.5 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 01/20/2023. Emergency Disaster Plan was last posted on 10/08/2022. First aid kit was observed to be complete. Fire drill was last conducted on 03/16/2022. Continued on LIC809. Continued from LIC809. Three (3) staff records were reviewed, and all staff have criminal record clearance and holds a current first aid certificate. All five (5) Clients records were reviewed. LPA observed the following deficiencies: At 2:37PM, LPA observed monitor sitting on kitchen counter watching R5 in bedroom. At 2:48PM, LPA observed three (3) unlocked cabinets located in kitchen containing medication. At 2:52PM, LPA observed locks on refrigerator and freezer in kitchen. At 2:54PM, LPA observed 3 pair of scissors in unlocked kitchen drawer and 1 pair in dish dyer sitting on counter top. At 2:55PM, LPA observed Clorox, Clorox disinfectant, Comet, knifes, and glade spray in unlocked cabinet underneath kitchen sink. At 3:05PM, LA observer shared residents' bathroom did not have non-slip mat in shower. At 4:15PM, LPA observed R1, R2, and R3 did not have doctor's orders for hospital bed with rails. LPA requested the following documents to be submitted to CCLD by 3/10/2023. LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Continued on LIC809C. Continued from LIC809C. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct deficiencies may result in Civil Penalties. Exit interview conducted. A copy of appeal rights and this report provided.