Routine inspection·May 4, 2024

On ##/##/## at 10:00am, Licensing Program Analyst (LPA)T.Syess-Gibson conducted an unannounced annual 1-Year required inspection. LPA met with Wilfredo Abarra, Caregiver, and explained the purpose of the visit. Administrator, Pramod Balanandan, arrived at 11:18AM. The administrator currently holds a certificate (#6050378740) that expires on 01/16/2025. The facility’s fire clearance was approved for six (6) ambulatory clients. LPA toured the facility with caregiver, Wilfredo Abarra, including but not limited to bedrooms, bathrooms, kitchen, common area, garage, and back yard. The facility consists of six (6) total bedrooms and two (2 ) bathrooms. All indoor passageways are kept free of obstruction. There are no bodies of water. A comfortable temperature for clients is maintained at 74 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the clients. Hot water temperature in the shared clients’ bathroom was measured at 101.9 degrees Fahrenheit. All toilets, hand washing, and bathing are safe, sanitary and in operating condition. Paper towel, and soap observed at all hand washing stations. The supply of extra hygiene was available for residents. There is a minimum of 7-day non-perishables and 2-day perishables foods. Smoke detectors/carbon monoxide were in operating condition during visit. Fire extinguisher was last services on 08/31/2023. Emergency Disaster Plan was last posted on 12/15/2023. Fire drill last conducted 01/17/2024. First aid kit was observed to be complete. Continued on LIC809C Continued from LIC809. Four (4) staff records were reviewed, and all staff have first aid certification. All six (6) clients' records reviewed, current, and complete. The following forms to be updated and submitted to CCLD by 05/11/2024: · Liability insurance. · LIC500 (Personnel Record) · LIC9020 (Client Roster) · LIC308 (Designation of facility Responsibility) · LIC400 (Affidavit Regarding Client/Resident Cash Resources) · LIC610E (Emergency Disaster Plan) LPA observed the following deficiencies: At 10:56AM LPA observed Clorox toilet cleaner under sink in common bathroom At 11:00AM LPA observed not all of the residents has the signal system in bedrooms At 12:24PM LPA observed during file review (R4) physician report states bedridden and facility isn't approved on fire clearance for bedridden residents Continued on LIC809C Continued from LIC809C * The total amount of civil penalties assessed on today's date is $500.00 for Fire Clearance Deficiencies are 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, LIC421IM and the appeal rights provided.