Routine inspection·January 4, 2024

On 1/04/2024 at 9:30AM, Licensing Program Analyst (LPA) Carol Fowler conducted an unannounced 1-Year Required inspection. LPA met with Chunjie Hu, and explained the purpose of the visit. Shengxi Liu, Co-Administrator arrived at 10:20pm. The Administrator certificate has expired as of 5/4/2023 and is working on renewal process. The Co-Administrator currently holds a certificate (#6043972740) that expires on 04/27/2025. The facility’s fire clearance was approved for five (5) non-ambulatory and three (3) bedridden residents. LPA toured the facility with Administrators including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of six (6) total bedrooms, and two (2) bathrooms. No bodies of water observed. A comfortable temperature is maintained at 72 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. However the light bulbs in both bathrooms need to be replaced. The hot water temperature in the residents’ shared bathroom was measured at 114.7 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 02/2/2022. Emergency Disaster Plan was last posted on 11/20/2023. First aid kit was observed to be complete. Facility did not have both Administrator and two (2) staff files including CPR/First Aid Certificates available. Four (4) residents files were reviewed were incomplete. Continued on LIC809C. Continued from LIC809. LPA observed the following deficiencies: · At 9:45am, LPA observed unlocked drawer in the kitchen with knives and scissors. · At 9:47am, LPA observed scrubbing bubbles disinfectant in unlocked cabinet underneath kitchen sink. · At 9:50am, LPA observed facility did not have 7-day of non-perishable and 2-day of perishable foods available for residents. Facility had expired non-perishable and freezer burned perishable food. · At 9:57am, LPA observed fish oil supplement and eye drops in an unlocked cabinet located in the kitchen. · At 10:05am, LPA observed air freshener, laundry detergent, propane, Lysol, ladder, wheelchair and other items in unlocked garage obstructing the walkway. · At 10:10am, LPA observed a room without a permit in the garage. · At 10:15am, LPA observed a building with two (2) rooms in the process of being build in the backyard with a permit or contacting CCLD before starting project. · At 10:18am, LPA observed hedge cutters, saw, ladder, sledge hammer, bleach, paint, shovel, pick ax and unlocked storage unit. At 10:40am, LPA observed staff files missing from the facility and resident files incomplete. Continued on LIC809C. Continued from LIC809C. LPA requested the following documents to be submitted to CCLD by 1/11/2024. · Resident Roster · LIC 308 Designation of Administrative Responsibility · LIC 309 Administrative Organization · LIC 500 Personnel Report · LIC 610E Emergency Disaster Plan (9 pages) · Liability Insurance The deficiencies were observed (see LIC809D) and cited from the California Code of Regulation, 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. *An immediate $1000.00 civil penalty will be assessed on today's date for associations.* Exit interview conducted. A copy of the LIC421BG, this report and appeal rights provided