Routine inspection·January 30, 2024

On 1/30/2024 at 3:30PM, Licensing Program Analysts (LPAs) L. Hall and T. Syess-Gibson conducted an unannounced 1-Year Required inspection. LPAs met with Caregiver Estrella Bumanglag , and explained the purpose of the visit. LPAs spoke with Administrator Kavitha Pramod via telephone. At 4:35PM the Licensee Pramod Balanandan arrived. The facility’s fire clearance was approved for four (4) non-ambulatory and two (2) bedridden residents. LPAs toured the facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area and back yard. The facility consists of six (6) bedrooms and three (3) bathrooms. All outdoor and indoor passageways are kept free of obstruction. LPAs did not observe any bodies of water. A comfortable temperature is maintained at 72 degrees Fahrenheit. LPAs 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 132.6 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 8/30/2023. Emergency Disaster Plan was last posted on 02/2019. First aid kit was observed to be complete. Fire drill was last conducted on 01/15/2024. Continued on LIC809. Continued from LIC809. Five (5) staff records were reviewed and four (4) our of five (5) were not first aid certified, and one (1) staff was not associated or had a file to review. LPAs reviewed all six (6) resident records. LPA requested the following documents to be submitted to CCLD by 02/06/2024. LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 610E Emergency Disaster Plan Liability Insurance LPA observed the following deficiencies: At 3:35pm, LPAs observed during record review and interview S1 was not associated to the facility. At 3:44pm LPAs observed unlocked kitchen cabinet with medication. At 3:45pm LPAs observed unlocked kitchen drawer with knives. At 3:54pm LPAs observed water temperature in shared restroom to be 132.6 Fahrenheit. At 5:28pm LPAs observed bedridden resident located in room number four(4). Per fire clearance bedridden should reside in either bedroom #2 or #3. At 5:56pm LPAs observed during record review four (4) staff were not first aid certified. Continued on LIC809C. Continued from LIC809C. * The total amount of civil penalties assessed on today's date is $100.00 for staff not being associated.* 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. A copy the appeal rights, LIC421BG, and the report provided.