Routine inspection·April 2, 2025

On 4/02/2025 at 9:50AM, Licensing Program Analyst (LPA) Carol Fowler conducted an unannounced 1-Year Required inspection. LPA met with Caregiver, Ma Nancy Ferrer and explained the purpose of the visit. The Administrator currently holds a certificate (#6043867740) that expired on 03/15/2025 and is waiting for renewed certificate. The facility’s fire clearance was approved for seven (7) non-ambulatory and one (1) bedridden residents. Administrator arrived at 12:30PM. LPA toured the facility with Caregiver then Administrator including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of eight (8) total bedrooms. There are five (5) full bathrooms. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water. A comfortable temperature is maintained at 75 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. Residents’ bathrooms are equipped with grab bars. Hot water temperature in the shared clients’ bathroom was measured at 105 degrees Fahrenheit. 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 10/16/2024. Emergency Disaster Plan was last posted on 03/22/2024. First aid kit was observed to be complete. Continued on LIC809C Continued from LIC809 LPA reviewed two (2) staff records, and all staff have criminal record clearance and holds a current first aid/CPR certificate. two (2) Clients records were reviewed all complete. DEFICIENCIES OBSERVED DURING VISIT: At 11:20AM LPA observed medication door was unlocked. At 11:23AM LPA observed a roach in a kitchen cabinet. At 11:26AM LPA observed a laundry room unlocked with the key hanging in the lock. LPA requested the following documents by 04/18/2025. LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations. Failure to correct deficiencies by POC date may result in additional Civil Penalties. Exit interview conducted, a copy of this report and appeals rights provided.