Routine inspection·May 14, 2024

On 05/14/2024 at 10:25AM, Licensing Program Analysts (LPA) T.Syess-Gibson conducted an unannounced 1-Year Required inspection. LPA met with Caregiver Hubert Omaguing, spoke with Administrator Marivic Datuin via telephone, and explained the purpose of the visit. The Administrator currently holds a certificate (#6056346740) that expires on 06/14/2024. The facility’s fire clearance was approved for six (6) non-ambulatory residents. LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and back yard. The facility consists of seven (7) bedrooms and four (4) bathrooms two (2) bedrooms used for staff. LPA did not observe any bodies of water. A comfortable temperature is maintained at 76 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 116.5 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and no skid 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 03/24/2024. Emergency Disaster Plan was last posted on 11/15/2023. First aid kit was observed to be complete. Fire drill was last conducted on 04/15/2024?. Continued on LIC809C. Continued from LIC809. LPA reviewed three (3) resident records and three (3) staff records, S2 and S3 missing Health Screening LPA requested the following documents to be submitted to CCLD by 05/21/2024 : · LIC 200 and Updated Facility Sketch · LIC 308 Designation of Administrative Responsibility · LIC 309 Administrative Organization · LIC 500 Personnel Report (Updated with Administrator available hours during normal business hours) · LIC 610E Emergency Disaster Plan LPA observed the following deficiencies: · At 10:36AM LPA observed unlocked drawer in kitchen with knives · At 10:45AM LPA observed unlocked drawer in rooms #3 and #4 joint bathroom with scissors · At 11:14AM LPA observed unlocked cabinet with medication · At 11:20AM LPA observed unlocked closet in garage with laundry detergent · A t 1:00PM LPA observed during personnel record review S2 and S3 missing Health Screening 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 of this report and appeal rights provided. Continue on LIC809D