Routine inspection·June 19, 2023

Licensing Program Analyst (LPA) Jose Villalobos conducted an unannounced Annual inspection focused on domains within the Compliance and Regulatory Enforcement (Care) Tools. LPA met with staff Josefina and explained the reason for the visit. Shortly after, the administrator Wilma Carstensen arrived and assisted with the visit. The following were observed/inspected: Physical Plant: The facility is a single story house and located in a residential neighborhood. The facility consists of four (4) residents bedrooms, two bathrooms, one live in staff room, kitchen, laundry area, staff office, dining room and a detached garage. The first and fourth residents bedrooms have two beds, two chairs, two drawers, and required linen and furniture and sufficient lighting and closet space. The second and third residents bedrooms have one bed, one chair, one drawer, required linen and furniture and sufficient lighting and closet space. The two residents bathrooms are clean and operational. The hot water temperature in the two bathrooms was measured within title 22 regulations. The food supply in the kitchen and pantry has at least two days perishable and seven days non perishable food. The front and back yard are free of debris and obstructions. The back yard has shaded area with tables and chairs for residents to use. All the appliances are clean and working properly. The common areas such as living room and dining room are clean and have the required furniture. The smoke detectors and carbon monoxide detectors are located in each residents bedrooms and common area and they are working properly. MEDICATION: Medications are stored, locked and inaccessible to residents. POSTINGS: All necessary postings were observed to be posted in appropriate places. A current Plan of Operations and Disaster plan is maintained at the facility. Operating telephone was observed and available for resident use. RECORD REVIEW: LPA reviewed four (4) resident files, four(4) residents medications, and three (3) staff files. A deficiency is being cited under the California Code of Regulations Title 22 Division 6 Chapter 8 and will be noted on 809-D page. An exit interview is conducted, copy of the report and appeal rights given was provided to the administrator.