Routine inspection·June 18, 2025

At 8:45a.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. Caregiver, Talado contacted Administrator via-phone and later Administrator joined today’s visit. At about 9:10a.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 extinguisher had a purchased receipt date of 05/03/2025. The smoke/carbon monoxide detectors are hardwired, interconnected and observed to be operational. They are located throughout the facility including hallway and bedrooms. Fire Emergency drill was last conducted on 04/14/2025. During this visit the facility is at 74 degrees Fahrenheit. The facility is fire cleared for six (06) non-ambulatory of which two (02) may be bedridden and a hospice waiver for three (03). The facility is currently occupying four (04) 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 at least two (02) days perishable and seven (07) Cont. on LIC 809-C days non-perishable food at the facility that is properly stored. Frozen foods are wrap 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 closet. 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. Bedrooms: LPA observed four (04) bedrooms designated for residents use. All bedrooms were toured and observed to be clean and properly furnished with appropriate dresser, beddings, and linens with sufficient lighting. Hallway is well lit. Bathrooms: LPA observed three (03) full bathrooms 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 118.2°F to 118.9°F and within the required range. Resident’s personal hygiene supplies are kept separate in their room. Towels and washcloths are not shared. Common Areas: These included the dining area, living and family rooms for residents. The common areas were properly furnished and observed to be in good repair. Residents dining table fits eight (08) people. 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. The facility has appropriate outdoor furniture with a covered shaded area for residents and visitors. The outdoor area was enclosed, and no bodies of water were observed. Garage: The garage stores extra supplies and observed to be locked and inaccessible to residents in care. Laundry Room: LPA observed a washer and dryer machines 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. Extra hygiene supplies are being stored in locked cabinet in the garage. 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 four (04) resident records were reviewed. Residents’ records are complete and current at this time. Residents 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 provided.