Routine inspection·April 16, 2025

On 04/16/2025 at 1:35PM, Licensing Program Analyst (LPA) Carol Fowler conducted an unannounced 1-Year Required inspection. LPA met with Caregiver Rosario Bolarde, spoke with Administrator, Maria Matel via telephone, and explained the of the visit. The Administrator arrived at 2:29PM. Administrator holds an Administrator Certificate (#7033531740) that expired on 01/29/2025. The facility’s fire clearance was approved for five (5) non-ambulatory and one (1) bedridden residents. LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and back yard. The facility consists of five (5) bedrooms, four (4) occupied by residents, one (1) occupied by staff and two (2) bathrooms. All outdoor and indoor passageways are kept free of obstruction. LPA did not observe any bodies of water. A comfortable temperature is maintained at xx 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 118.1 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 not tagged for purchased or being serviced. Emergency Disaster Plan was last posted on 04/16/2025. First aid kit was observed to be complete. Continued on LIC809C. Continued from LIC809. LPAs requested the following documents to be submitted to CCLD by 04/23/2025. LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance LPAs observed the following deficiencies: At 2:05pm LPA observed medications in an unlocked cabinet in the garage and staff office At 2:06pm LPA observed washing detergent unlocked located in the garage At 2:12pm LPA observed matches and fire place lighter located in an unlocked drawer located in the kitchen At 3:15pm LPA observed R1 was missing a medical assessment (LIC602) At 3:40pm LPA observed the facility has not conducted fire/disaster drills 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.