Routine inspection·September 25, 2024

On 9/25/2024 at 9:10 AM, Licensing Program Analyst (LPAs) A. Gomez and P. Manalo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Tayyaba Chaudhry and explained the purpose of the visit. The facility’s fire clearance was approved for 6 non-ambulatory of which one may be bedridden in room 3. LPAs toured facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 7 total bedrooms which 6 bedrooms are occupied by the residents and 1 bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 78 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 117.8 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 medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 01/10/2024. Emergency Disaster Plan was last posted on 01/01/2024. First aid kit was observed to be complete. Emergency disaster drill and fire drill was last conducted on 07/28/2024. At 10:30 am, LPA reviewed 6 residents records. At 11:15 am, LPA reviewed 4 staff records and 4 of 4 have current first aid training and associated to the facility. Report Continues on LIC 809-C THE FOLLOWING DEFICIENCY WERE OBSERVED DURING VISIT: At 10:30 am, LPAs observed a full bed rail in R6's room. Administrator removed the bottom rails, POC cleared. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 10/02/2024: LIC 500 Personnel Report LIC 610E Emergency Disaster Plan The following deficiency was observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code. Failure to correct deficiency by POC date may result in additional Civil Penalties. Exit interview conducted. Appeal Rights and a copy of this report provided.