Routine inspection·March 4, 2022

Licensing Program Analyst (LPA) Tao conducted an unannounced annual inspection visit. LPA met with Linda Morales, Licensee and Stacy Lopez, lead manager who assisted with visit. The facility has a capacity of six (6) residents. It is licensed to serve six (6) bedridden residents age 60 and above. Facility approved for one (1 ) hospice waiver. Linda Morales was informed of the annual licensing fees being overdue. Prior to LPA's departure, Mrs. Morales submitted on-line payment for the licensing fees and provided confirmation to LPA. Administrator certificate is current and the expiration date is 01/03/23. During the visit, the infection control domain tool was used, a tour of the facility was conducted, food supply was reviewed, and medications were reviewed. The facility is located in a residential neighborhood. The property ground is a duplex lot with two (2) facilities. The front house is facility, Con Carino, and the back house is The Cottage. The Cottage facility has four (4) bedrooms, two (2) bathrooms, living room, dining room, kitchen, front yard, and backyard area. Facility has an attached garage that is locked and utilized for additional storage of items. A physical tour was conducted. Residents’ rooms were well furnished and in compliance. Bathrooms inspected were clean, operable, with the required grab bars and non-skid materials in the shower. Adequate linen and personal hygiene supplies was observed. (-continued in LIC 809 C-) No pools and bodies of water on the premises. No firearms on the premises. Facility maintained a comfortable temperature for residents. Auditory alarm devices to monitor exits were operable. Interior and exterior space available to permit residents to wander freely and safely. Sufficient supply of perishable and nonperishable foods is observed. Knives, tools, sharp items are inaccessible to residents. Carbon monoxide devices are combined with smoke detectors and operable. Fire extinguishers are fully charged. Mandated documents and signages are posted in common areas. The outdoor activity area has a shaded patio with ample seating. Medication are centrally stored in a locked cabinet in the kitchen and inaccessible to residents. Resident records are stored in a locked cabinet and inaccessible to residents. Toxic substances are inaccessible to residents. Outdoor facility space used for residents and leisure are completely enclosed by a fence with self-closing gates. Deficiency was observed and cited per California Code of Regulations, Title 22 in LIC 809 D. An exit interview was conducted. This report is discussed and provided to facility Licensee /Administrator, whose signature on this form confirm receipt of these documents. A copy of appeal rights was provided.