Routine inspection·May 8, 2025

On May 8, 2025, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Executive Director Carla Chan. LPA explained the purpose of today’s visit. The facility is licensed to serve ambulatory and non-ambulatory elderly adults ages 60 and above. The facility is approved for (15) hospice residents. Currently, the facility has (5) residents on hospice care. The facility is a two-story structure located in a commercial neighborhood. It consists of the following: (108) resident bedrooms. Each room has a bathroom in the unit. The facility houses an activity room, dining area, kitchen, beauty shop, administrative offices, and outside patio area. LPA toured the physical plant. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, and storage for the resident's personal belongings was observed. Bathrooms were found to be within Title 22 regulations and were operational. LPA inspected rooms: #111; #113; #127; #135; #138; #141; #207; #212; #217, and #224. The water temperature range from 105.0 - 106.9 degrees F. and room temperature range from 74 - 75 degrees F., call buttons, and smoke and carbon monoxide are all in operating condition. LPA observed the facility to be sanitary and appropriately furnished at the time of the visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. All fire extinguishers were charged. A review of Fire & Earthquake Drills were completed for AM, PM and NOC shift on 04/01/25 and 04/04/25. Several working landline phones are available on-site. A review of Medication Administration Records found to be in order and accurate. Evaluation Report continues on LIC 809C During the visit LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. All mandated inspection control posters, including the Activities Calendar and Food Menu, were posted. The facility included stairway evacuation chairs in all the stairwells. An audit of resident's service records for resident #1-#6 (R1-R6) and staff personnel records for staff #1-#6 (S1-S6) were accurate and complete. The facility is current on Community Care Licensing annual fees. The facility has a current administrator certificate on file for Chan Carla #7001104740 05/04/2023 through 05/03/2025 RCFE. The facility has a Liability Insurance Certificate valid with policy # 01341969 effective 03/01/25 through 03/01/2026. No Deficiencies were identified during this inspection visit. An exit interview was conducted, and a copy of this report was provided to Carla Chan.