Routine inspection·June 30, 2025

On 06/30/25 at 10AM, Licensing Program Analyst (LPA) Carol Fowler arrived unannounced to conduct an annual required inspection. LPA met with Care Staff Anthony Merida and explained the purpose of the visit. Administrator Carolyn Daniels arrived at 11:00AM. Administrator has current administrator certificate# 7034379740 which expires on 08/04/2025. LPA toured the facility including but not limited to bedrooms, bathroom, dining area, kitchen, garage, and outdoor area. Smoke and carbon monoxide detectors were observed and in working condition. Fire extinguishers were observed to be full and last serviced on 02/01/2024. One week of nonperishable and 2-day of perishable food supplies were available. LPA observed a non-skid mat in the bathroom. There were adequate lights in each room. First Aid kit is complete. No documentation on when the Last disaster drill was conducted. LPA reviewed 3 clients and 3 staff files. Staff files were complete. Resident files were not complete complete. Staff were fingerprint cleared and associated to the facility. LPA reviewed a sample of client's medications during inspection. LPA measured hot water at 107.6 degrees F in the hallway bathroom. CONTINUE ON LIC 809C CONTINUE FROM LIC 809 Deficiencies observed during visit: No emergency and disaster plan. No documentation of a disaster drill conducted. Expired fire extinguisher. soiled carpet throughout the facility, spider webs and dust on the curtains in the bedrooms and on side of a dresser in room number 2, bedroom doors need to be repainted, closet door in bedroom 1 need to be replaced and cleaned. bathroom sink, bathtub, floors need to be clean and disinfected, door needs to be repainted. kitchen counter has a tile missing on the counter top, freezer in the garage leaking and needs to be cleaned, kitchen chairs need to be cleaned and sanitized, refrigerator inside and out needs to be cleaned and sanitized, oven needs to be replaced. Weeds in the front, back and side yards need to be cut and removed incomplete resident records Provide a copy of updated documents by 7/08/2025:  LIC500- Personnel Report  Resident Roster  LIC308- Designation of Facility Responsibility  LIC610E- Emergency/Disaster Plan including infection control plans  Evidence of Liability Insurance The deficiency was observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct the deficiency may result in civil penalties. Exit interview conducted with Carolyn Daniels. A copy of this report and appeal rights were provided.