Routine inspection·June 9, 2025

At 9:45a.m., Licensing Program Analyst (LPA) Antonia Alvizar-Ettima conducted an unannounced Required One (1) year inspection to the facility. LPA met with caregivers that granted entry to the facility and explained the reason for the visit. Later, Administrator joined today’s visit. At 10:30a.m., LPA and Administrator conducted a physical plant tour inside and out. During the tour, LPA observed that the facility is a home located in a residential community. Required postings were observed in the dining area. The facility has fire sprinklers throughout the home and fire extinguishers were observed. Fire extinguishers charge date is 02/05/2025. There were combo smoke/carbon monoxide detectors in each bedroom and hallway. Fire/Earthquake emergency drill was last conducted on 05/19/2025. During this visit the facility is at 73 degrees Fahrenheit. The facility is licensed for six (06) residents over the age of 60, six (06) bedridden, hospice waiver for six (06) residents. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Kitchen: LPA observed kitchen appliances and fixtures were functional. The kitchen has a working gas stove, faucet, freezer, refrigerator, and microwave. LPA found enough at least two (02) days perishable and seven (07) days non-perishable food at the facility that is properly stored. Frozen foods are wrap, dated, and stored properly as well. Knives were stored in a locked drawer in the kitchen. Food storage and preparation areas are clean and inaccessible to pests. Garbage cans have tight fitting covers. Cleaning supplies, pesticides or toxic cleaning supplies were stored and locked away in the kitchen under the sink. Cont. LIC 809-C Cont. LIC 809 Bedrooms: LPA observed four (04) bedrooms designated for residents use and one (01) bedroom designated for staff. All bedrooms were toured and observed to be clean and properly furnished with appropriate dresser, beddings, and linens with sufficient lighting. Bathrooms: LPA observed two (02) full bathrooms and a half (1/2) bathroom to be clean, sanitary and with necessary supplies. The appropriate grab bars and mats in the shower. Hot water temperature measured at a range of 116.9°F to 117.2°F and within the required range. Resident’s personal hygiene supplied are kept separate in caddy container stored in a locked cabinet under the sink. Towels and washcloths are not shared. Common Areas: These included the living room and dining area for residents. The common areas were properly furnished. Furniture in common area was observed to be in good repair. Residents dining table fits six (06) residents. No obstructions and or tripping hazards throughout the facility. There are no issues with Fire Clearance. Surrounding Grounds : Entry and exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. The outdoor area was enclosed, and no bodies of water were observed. Garage is detached from the house and observed to be locked and inaccessible to residents. The garage stores extra supplies and utilized as parking. Laundry Room: LPA observed a washer and dryer machine located next to the kitchen. Linens are stored in the hallway cabinet and observed to have ample supply of clean linen, comforters, and towels in facility. Cleaning and extra hygiene supplies are being stored in locked cabinets in the hallway. Medications: are in a centrally stored and locked medication cabinet the in kitchen, including over-the-counter medicines; medications are properly labeled and checked for expiration dates. Each centrally stored prescription and PRN medication has been logged in the medications log with proper documentation from the resident’s doctor. First-aid has all proper items and were observed to be stored in locked cabinet in the kitchen. Staff Files : were reviewed they all have criminal record clearances and associated to this facility. Staff have current first aid and training documentation showing training completed. Administrator's certificate was observed to be current. Resident Records : All three (03) resident records were reviewed. Residents’ records are complete and current at this time. Resident were also interviewed. Facility is within CA code of Regulations Title 22 or Health and Safety Code. No deficiencies were found, exit interview conducted, copy of report has been issued and discussed.