Routine inspection·August 9, 2022

On 8/9/22 at 01:00 p.m., Licensing Program Analyst (LPA) Jewel Baptiste conducted an unannounced visit for the purpose of conducting the required annual inspection. On today's visit LPA met with Administrator, Rowena Carrillo who assisted with today’s visit. The home is licensed to serve a capacity of six elderly residents age 60 and above, of which all may be non-ambulatory. Bedridden fire clearance approved for bedroom #1 and an approved Hospice Care waiver for two residents at any one given time. The facility is a single-story building in a residential area, with a kitchen, dining room, 2 living room, 4 bedrooms, 2 bathrooms, backyard with shaded area. Fire extinguisher observed kitchen fully charged. There are smoke detectors/ Carbon monoxide located throughout the facility, tested and operational. LPAs discussed infection control practices with administrator, toured the facility inside and out, reviewed food supply, reviewed staff files, and reviewed resident medications. Report continued 809c Bedrooms have the required furniture including bedframes, dressers, lamps, and chairs. Beds have the required linen and the linen is in good condition. Passageways and exits are free of obstruction. LPA toured the kitchen and observed 7 days of perishables and 2 days nonperishable. The backyard was observed to have a lot of storage materials and debris. Administrator stated it will all be removed in a week. The resident bathrooms are clean, and showers have grab bars and non-skid materials. The hot water temperature measured at 84.3 - 99.3 degrees F, which is not within the required 105-120 degrees F. The facility temperature at the time the visit was comfortable. There is sufficient lighting throughout the facility. LPA observed a sufficient supply of PPE. Infection control signs were observed throughout the facility. Medications reviewed for all clients and appears to be given as prescribed. Facility file reviewed revealed administrator certificate # 6014763735 expire 3/26/2023. Last emergency disaster drill 2/20/22. Pursuant to Title 22 code of regulations, the following deficiencies were cited (refer to LIC 809-D): Exit Interview Conducted with Administrator / Appeal Rights Provided / A Copy of the Report Issued to Administrator.