Routine inspection·October 24, 2024

On 10/24/2024 at 10:11AM, Licensing Program Analyst (LPA) T. Syess-Gibson conducted an unannounced 1-Year Required inspection. LPA met with Caregiver, Carla Page and explained the purpose of the visit. The Administrator currently holds a certificate (#7016298740) in pending status per CCLD Portal. The facility’s fire clearance was approved for three (3) ambulatory and four (4) non ambulatory residents. LPA toured the facility with Caregiver, Carla Page including but not limited to bedrooms, bathrooms, kitchen, common area and back yard. The facility consists of seven (7) bedrooms, One (1) occupied by staff and four (4) bathrooms. All outdoor and indoor passageways are kept free of obstruction. LPA observe a pool behind a properly secured locked gate in the backyard . A comfortable temperature is maintained at 81 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 118.7 degrees Fahrenheit. Residents' bathrooms are equipped with grab bars and nonskid mats. 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 purchased on 10/19/2024. Emergency Disaster Plan was last posted on 11/09/2023. First aid kit was observed to be complete. No fire drill conducted with residents as of today. Continued LIC809C. Continued from LIC809. LPA reviewed five (5) resident records and five (54) staff records during visit The following forms to be updated and submitted to CCLD by 10/31/2024: · LIC 500 Personnel Report · LIC 400 Affidavit Regarding Client/Resident Cash Resources · LIC 402 Surety Bond · LIC610E Emergency Disaster Plan · LIC308 Designation of facility responsibility LPA observed the following deficiency: · At 10:55AM LPA observed the following items in laundry room in an unlocked cabinet: Cutter& Repel Sportsman- Insect Repellent, Swan- Rubbing Alcohol and Marquee- Hydrogen Peroxide Deficiency is cited per Title 22 California Code of Regulations and listed on LIC809D. 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 and a copy of this report and appeal rights provided to Carla Page Continued LIC809D