Routine inspection·November 18, 2023

On 11/18/2023 at 8:30 am Licensing Program Analyst (LPA) David España conducted an unannounced Required-1-year annual visit. Upon arriving at the facility, LPA met Ivan Bravo, Administrator who assisted with the visit. The purpose of today’s visit was discussed. Upon arrival at the facility, LPA conducted a risk assessment at the front door. Based on the assessment, the facility is clear of Covid-19 infection. LPA was granted access and allowed to enter the facility to conduct inspections. LPA met with Administrator Ivan Bravo and explained the purpose of today’s visit. The facility is a Residential Care Facilities for the Elderly (RCFE) licensed for six (6) non-ambulatory clients. Currently, there is three (3) residents residing in the facility, all 60 or older. The facility is a two-story structure located in a residential neighborhood. It consists of the following: four (4) resident rooms downstairs with two bathrooms, living room, dining room, kitchen, outside laundry room. The second floor consists of three (3) staff bedrooms, an office, and spare room. No weapons are stored in the premises. Kitchen was inspected and observed to be clean and operational. LPA and Administrator toured the physical plant. There were no bodies of water or obstructions on the premises. Beds and bedding supplies were in good condition, adequate lighting provided, storage for client personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Toilets and water faucets worked properly, grab bars were secure, the shower was free of mold/mildew, and a non-skid mat was in place. There are no security bars or weapons on the premises. The water temperature measured at 108.8 degrees Fahrenheit and 120 degrees Fahrenheit. Bathrooms were found to be within Title 22 regulations and were clean and operational. LPA observed the facility to be sanitary and appropriately furnished at the time of visit. Cleaning supplies and toxins, sharps objects are stored in locked kitchen drawers and cabinets, locked and not accessible to clients. The kitchen was inspected and there is a 2-day supply of perishable and a 7-day supply of non-perishable food available, maintained properly. Facility Evaluation Report continued LIC-809-C Two (2) fully charged fire extinguishers were found in both upstairs and downstairs hallway that were charged, smoke detectors, and carbon monoxide were operable. During the visit, LPA observed that the facility has an approved Mitigation Plan Report on file with CCLD.LPA observed staff were wearing face coverings, all mandated inspection control posters were posted. There were deficiencies cited during this inspection visit. Staffing - Type B: 1569.618(c)(3) - Licensing Program Analyst (LPA) David España. and Ivan Bravo, Administrator did not observe First Aid Training for Staff #1-#3. Resident Rights/Information - 87468(c)(2)(A) - Licensing Program Analyst (LPA) David España. and Ivan Bravo, Administrator did not observe PUB 475 20"X26" posted at the main entryway of the facility. Disaster Preparedness - Technical Violation: 1569.695(a)(5) - Licensing Program Analyst (LPA) David España and Ivan Bravo, Administrator did not observe LIC 610 Emergency Disaster Plan. Advisories are on attached 9102. An exit interview was conducted, and a copy of this report and appeal rights was provided to Ivan Bravo, Administrator.