Routine inspection·April 20, 2023

On 4/20/2023 at 12:00PM, Licensing Program Analyst (LPA) C. Fowler conducted an unannounced 1-Year Required inspection. LPA met with Administrator, Romeo Lodia and explained the purpose of the visit. The Administrator currently holds a certificate (#6034539740) that expired on 04/13/2023, Administrator has submitted forms and training's for renewal on 01/26/2023 and is waiting for license. 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 backyard. The facility consists of four (4) total bedrooms which three (3) bedrooms are occupied by residents, one (1) vacant and one (1) staff quarters on the grounds. There are three (2) full bathrooms. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water. A comfortable temperature is maintained at 71 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. Residents’ bathrooms are equipped with grab bars. Hot water temperature in the shared clients’ bathroom was measured at 117.9 degrees Fahrenheit. 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 01/25/2023. Emergency Disaster Plan was last posted on 04/18/2023. First aid kit was observed to be complete. Fire drill was last conducted on 04/04/2023. Continued on LIC809C 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 1:13PM, LPA observed Glade bathroom spray, Zep hardwood floor cleaner, and Lysol located under the bathroom sink. LPA requested the following documents to be submitted to CCLD by 04/27/2023. LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance 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.