Routine inspection·March 9, 2024

Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced visit today for the facility’s annual inspection. LPA met with Facility Staff, Nicholas Alvidrez, Continual Administrator's Certification Licensee Robert Norman expires 06/17/2025. There are currently 23 residents who reside at this home and there is 7 residents on hospice at this time. LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, activity rooms, medication storage, kitchen, and outdoor areas. Bedrooms were clean and in good repair. There is a locked storage for medications. Food supply is adequate for 2-day perishable and 7-day nonperishable. Fire extinguisher is within the safety regulation period. Smoke alarms were tested and are operational. The facility does not have documented disaster drills as required. First Aid kit is on site and complete. Toxins and cleaning supplies are locked and inaccessible. Water temperature measures 116 degrees. LPA Hurt observed cleaning supplies in the kitchen near food items. Resident 1 does not have updated yearly Physician's Report as required. Resident 2 does not have required "Oxygen in Use" sign on door. Resident 3 does not have completed Admission Agreement in file. Staff does not have required / updated dementia training. Resident 4's medications are pre poured, and not in original containers. The facility entrance smells of urine, and several areas in the facility need dusting and deep cleaning. The following deficiencies observed or cited during today's inspection per California Code of Regulations, Title 22. LPA requested the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing. Exit interview conducted with Facility Staff, Nicholas Alvidrez, and copy of report left at facility