Routine inspection·October 11, 2023

On 10/11/2023, Licensing Program Analyst (LPA) Alfonso Iniguez conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Jemimah Mejia /Administrator. LPA explained the purpose of today’s visit. The facility is licensed to serve (6) residents ages 60 and above of which (5) may be non-ambulatory and (1) bedridden. Facility has an approved hospice waiver for (4) residents. 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 Iniguez toured the physical plant with staff. There were no obstructions on the premises. Beds and bedding supplies were in good condition, adequate lighting was provided, and storage for the resident’s personal belongings was observed. Bathrooms were found to be within Title 22 regulations and were operational (See D page for citation). LPA inspected rooms: #1, #2, and #3, smoke and carbon monoxide combo are all operable conditions. The water temperature properly measured between 105°-120°F: Kitchen 108.6°F, Bathroom #1:106.9°F. Evaluation Report Continues LIC 809-C LPA Iniguez observed the facility to be sanitary and appropriately furnished at the time of the visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents (See D page for citation). The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. All fire extinguishers were charged and were operable. A review of (3) residents' service files, (3) staff personnel files and (3) Medication Administration Records (MAR) were maintained in order. First AID kit was checked. Last facility disaster drill was on:6/2/2023 A copy of the liability insurance was provided to LPA during visit. LPA observed the facility's infection control practices. Deficiencies cited under California Code of Regulations, Title 22, Division 6, Chapter 8. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Jemimah Mejia /Administrator.