Routine inspection·September 13, 2022

On 09/13/2022 at 11:30 am, Licensing Program Analyst (LPA) Lourdes Montoya conducted an unannounced Required – 1 Year Inspection and met with two caregiver Michael San Agustin (S1) and Eyla Aguil (S2). LPA explained the purpose of the visit. Staff Jemimah Mejia arrived shortly after and assisted LPA with the visit. There were six (6) clients and three (3) staff present in the facility during this inspection. Facility is licensed licensed to serve clients age 60 and over, five (5) non-ambulatory and one (1) may be bedridden. Approved Hospice Waiver for four (4). The Annual Licensing Fees are current. Rooms "A" only as approved for one bedridden. LPA observed a bedridden resident sleeping in bedroom B (or #2). The facility is a single story structure located in a residential neighborhood. It consists of the following: 4 bedrooms, 2 bathrooms, living room, kitchen, dining room, family room/office, shaded area (side yard and front yard), utility room and an attached garage. LPA Montoya toured and inside and outside grounds of the facility with Staff Mejia. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for resident personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured 105.2 degree Fahrenheit. A comfortable temperature was maintained in the facility. LPA observed the facility was found to be appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food supplies. The facility has (2) fire extinguishers that were charged, smoke detectors, and carbon monoxide were operable. The facility conducted a Fire/Safety Drill on 6/15/2022. A working telephone remains available. Evaluation Report Continues on LIC 809-C During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for residents, staff and visitors, and sanitizing stations in common areas and restrooms. LPA observed staff were wearing face coverings, LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. The facility has an approved Mitigation Plan Report on file with CCLD. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA observed deficiencies and issued citations. $500.00 Civil penalty assessed. LPA was unable to provide a hard copy of the report due to technical difficulties. An exit interview was conducted with Staff Jemimah Mejia. LPA will email an electronic copy of the report with appeal rights and civil penalty to Staff Jemimah Mejia for signatures.