Routine inspection·July 7, 2025

On 07/07/25 Licensing Program Analyst (LPA) Evelin Rios arrived at the facility to conduct an unannounced annual inspection. Upon arrival, LPA was greeted by staff. Staff contacted the administrator and informed them LPA was at the facility. LPA spoke to the administrator designee, Beatriz Vasquez by telephone and informed her the reason for the visit. Administrator, Natividad Arayata will be unable to meet LPA at the facility due to a prior appointment. LPA met with administrator designee at 1:20 p.m., but they could not stay to sign todays report and designated staff, Joana Escario to sign todays report. At 10:36 a.m., LPA conducted a physical plant tour of the facility inside and out and the following was observed: At entry LPA observed appropriate postings on the wall, sign in log for visitors and a digital thermometer affixed to the wall. Common Areas : These included the living areas and dining area. The common areas were clean, clear of clutter and properly furnished. Dining table and couches sit the capacity of the facility. LPA did not observe any tripping hazards. In the office area LPA observed a second television and board games for residents to use. Records were observed locked in a filing cabinet in the office area Kitchen: The kitchen appliances and fixtures were observed functional. LPA found a sufficient amount of 2-day perishable and 7-day non-perishable food at the facility, properly stored. LPA observed knives and sharps were stored in a locked kitchen drawer and cleaning supplies were locked in a kitchen cabinet. LPA observed medications were locked in a kitchen cabinet. LPA observed a facility telephone accessible to residents. LPA observed a small locked fridge with medication requiring refrigeration. (Continued on LIC809-C) Surrounding Grounds : Entry/exits were free of obstruction. The outdoor area was free of hazards. There is a shaded area for residents. LPA observed a locked shed used for storage. No bodies of water observed. Bedrooms: There are five (05) bedrooms designated for residents' use and one (1) is shared. Bedrooms occupied by residents were properly furnished with appropriate bedding, linens, sufficient lighting and required furniture. Hallway closet by the bedrooms was observed to store extra linens. The facility keeps a comfortable temperature of 76 degrees Fahrenheit. The auditory alarms on all exit doors were on and functional at the time of the visit. Bathrooms: There are three (3) bathrooms. One (1) is located in the shared bedroom. Bathrooms were properly supplied and had functional fixtures. Hot water temperature was taken from two (2) bathroom at 10:55 a.m., and read between 118.8 and 118.2 degrees Fahrenheit, within compliance. The smoke alarms are hard wired and interconnected. Staff tested the dual smoke and carbon monoxide detector at 11:05 a.m., and they were observed to be functioning properly. The fire extinguisher is located in the kitchen and was observed fully charged with purchase date 07/08/2024. Garage/Laundry: The laundry room is kept locked and inaccessible to residents in care. Detergents and cleaning products are kept in the laundry room locked. LPA also observed extra hygiene products in the laundry room. The locked laundry leads to the garage . In the garage LPA observed a freezer and a second refrigerator with a over flow of food.. Resident Files / Staff Files/ Facility File s: At 11:09 a.m. LPA conducted a file review of six (6) out of six (06) resident records to insure compliance of licensing forms. Residents' Medication and Medication Records were reviewed for proper documentation. At 12:26 p.m., LPA also conducted a file review of three (03) staff records and facility records to insure forms and training are up to date and in compliance with licensing forms. LPA reviewed facility's Certificate of Liability Insurance, Personnel Report (LIC 500), Infection Control Plan, last conducted emergency disasters drills, and Emergency Disaster Plan (LIC 610E). Pursuant to Title 22 Division 6 of the CA Code of Regulations, no deficiencies observed during todays visit. Exit Interview Conducted. A copy of the report Issued.