Routine inspection·November 18, 2022

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced Annual Required / Infection Control visit to the above facility. LPA was met by Caregivers, Lorna Alcantara and Jojo Aguilar. LPA was screened for Covid-19 including temperature check and asked to sign in the guest book by caregiver Jojo Aguilar and the purpose of today’s visit was explained. Administrator, Michelle Navarro arrived at 12:35pm and assisted LPA with the inspection. There are currently six (6) residents in the facility, (3) of which are hospice. The facility is licensed to serve elderly residents, all rooms are cleared for non-ambulatory residents. Hospice waiver approved for three (3) out of six (6) residents. LPA and Administrator inspected the entire facility inside and out. The facility is a single-story home located in a residential neighborhood, (6) bedrooms, (3) bathrooms, living room, family room, dining room, kitchen, attached garage/activity area, laundry area, backyard, covered patio area. At 12:45pm, LPA and the Administrator toured the facility. The following was observed/inspected: The facility had a universal entrance screening area; sign-in and temperature logs were maintained. COVID-19 signage was placed in several areas of the facility including the front entrance. All areas were found to be clean and in good repair. Facility maintained a 30-day supply of PPE to include masks, gowns, and face shields, all stored in the garage area. Staff wore face masks consistently throughout the shift. All resident bedrooms were toured. Each room contained required furniture including bed, dresser, nightstand, lamp, chair, and closet. All beds contained the required linens including mattress cover, fitted sheet, flat sheet, blanket, and comforter. Bathrooms are clean and operational and were observed to be within Title 22 regulations. Toilets and water faucets worked properly. Shower was free of mold/mildew, adequate lighting, and sufficient toiletries are accessible to clients. Bathrooms contained supplies including liquid soap, toilet paper, and paper towels. At 12:50pm, hot water temperature was checked and read 112.7 deg. F in the kitchen sink, bathroom #1 118.9 deg. F, in bathroom #2, 118.2 deg. F in bathroom #3 and 118.6 deg. F, all are within the required 105.120 degrees. Kitchen was inspected and LPA observed sufficient perishable and non-perishable food. All the appliances are clean and are operating properly. There is a 2 nd freezer in the garage/activity area with additional food supplies. Knives and other sharp items are stored and locked in a kitchen cabinet which are inaccessible to residents. Hazardous toxins, dishwashing soap and/or other cleaning items are also locked under the kitchen sink and inaccessible to residents. Laundry room is located inside the garage and there are cabinets with locks where they store the PPE supplies. Some hazardous cleaning supplies and laundry detergents are also stored in the locked cabinets in the garage and inaccessible to residents. Exit, walkways and/or passageways, front and back yard are free of debris and/or hazards. A shaded area with chairs is provided for residents in the patio area. The facility is in good repair and Facility temperature was comfortable and read at 75 deg. F. First aid kit is fully stocked with manual, smoke detectors and carbon monoxide detector were in compliance and operational. No firearms are stored at facility and no bodies of water present. All residents' medications were reviewed, and LPA observed that medications are stored, locked in one of the kitchen cabinets and inaccessible to residents. Medications are documented properly and given as prescribed. All Staff and residents are fully vaccinated with booster shots. Smoke detectors/carbon monoxide detectors, auditory device in the bedrooms were present and operable. Two (2) fire extinguishers were observed to be new and fully charged. One (1) is in the kitchen/dining area and the other one is in the garage/activity area. Per California Code of Regulations, Title 22, there were no deficiencies observed during the visit. An exit interview was held, and a copy of the report was provided to Administrator, Michelle Navarro.