Routine inspection·October 8, 2024

On 10/08/2024 at 11:05 AM, Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Executive Director, Liza "Gigi" Elegado and explained the purpose of the visit. The facility’s fire clearance was approved for 49 Resident capacity in which all may be non-ambulatory. Approved hospice waiver for 10 Residents. LPA toured the facility with Gigi including but not limited to 4 residents apartments, bathrooms, multiple activity rooms, kitchen, common area and courtyard. There are no bodies of water observed. LPA observe lighting in all rooms are adequate for the comfort and safety of the residents. Hallway temperature was maintained at 76 degrees F. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in a sample of residents’ shared bathroom were measured at 105 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 medications, sharps and toxic are locked and inaccessible to residents in care. LIC809-C Continued... 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. THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: At 3:20pm, chairs and chest dresser drawer outside At 3:25pm, cracked siding and flooring in hallway common area and outside resident's rooms At 3:29pm, broken wood and metal on the west side of building outside At 3:30pm, Shop-Vac, dryer/washing machine, upholstered recliner chair outside near front entrance Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 10/24/2024: LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Updated Facility Sketch Liability Insurance Exit interview conducted. Appeal Rights and a copy of this report provided.