Routine inspection·August 20, 2024

On 08/20/2024 at 1:20PM, Licensing Program Analyst (LPA) Carol Fowler conducted an unannounced 1-Year Required inspection. LPA met with Mariazita Jardeleza and explained the purpose of the visit. Velba Villanueva, Administrator arrived at 2:50pm, the Administrator currently holds a certificate (#6024026740) that expired on 05/18/2024. The facility’s fire clearance was approved for four (4) non-ambulatory residents. LPA toured the facility with Caregiver including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of three (3) total bedrooms which one (1) bedroom is occupied by staff. No bodies of water observed. A comfortable temperature is maintained in the home. 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 113.7 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 last serviced on 05/04/2022. First aid kit was observed to be complete. Continued on LIC809. Continued from LIC809. LPA reviewed three (3) staff files all are complete. One (1) resident file was reviewed and complete. LPA observed the following deficiencies: At 2:00pm, LPA observed cleaning solutions Windex, Ajax, Fabuloso in the bathroom cabinet and Cascade and Ajax in the kitchen cabinet unlocked . At 2:07pm, LPA observed the fire extinguisher was expired. At 2:20pm, LPA observed 5 unlocked storage doors unlocked, 3 ladders, paint, large tool box unlocked with tools, electric saw, wood planks, pick hoe garden tool, 3 shovels, wheelbarrow, and 3 scooters, located in the open porche area LPA requested the following documents to be submitted to CCLD by 09/10/2024. Resident Roster LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Copy of Administrator Certificate 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. Exit interview conducted. A copy of appeal rights and this report provided.