Routine inspection·September 12, 2024

Licensing Program Analyst (LPA) Tao conducted an unannounced annual inspection visit. LPA met with Gladys Pervez, administrator who assisted with the visit. The facility is licensed to serve one (1) bedridden and five (5) non-ambulatory residents (ages 60 and above). The facility has an approved five (5) Hospice Waivers. Two (2) hospice residents are residing at the facility. Annual licensing fees are current. Administrator certificate is current and the expiration date is 02/08/25. During the visit, the CARE tool was used, facility was toured, staff/residents were interviewed, staff/residents records were reviewed, food supply was reviewed, and medications were reviewed. The facility was located in a residential neighborhood. The facility consisted of four (4) resident bedrooms, two (2) bathrooms, living room, dining room, kitchen, garage equipped with a laundry area and an indoor/outdoor activity area. No pools and bodies of water on the premises. All residents' bedrooms and bathrooms had appropriate furnishing and in compliance. Common areas were observed for the ability to safely serve the needs of the residents. Hot water temperature was 116.3 degrees Fahrenheit which was within Title 22 Regulation guidelines. Adequate linen and personal hygiene supplies was observed. Auditory alarm devices to monitor exits were operable. Last fire drill was conducted on 9/3/24. Sufficient supply of perishable and nonperishable foods was observed. Sharp items were inaccessible to residents. Smoke detectors and carbon monoxide detectors were operable. Fire extinguishers’ last service was 4/24/24 on and are fully charged. Medication was centrally stored in a locked cabinet; resident records were stored in a locked room and both inaccessible to residents. Toxic substances were inaccessible to residents. Outdoor facility space for residents' leisure were completely enclosed by a fence with self-closing gates. No deficiencies were observed and cited per California Code of Regulations, Title 22. An exit interview was conducted and LIC 809 report was discussed with Administrator, Gladys. A copy of LIC 809 report was provided.