Routine inspection·September 8, 2023

Licensing Program Analyst (LPA) Melissa Spaeth and Lorena Casillas conducted an unannounced visit and was greeted by the two caregivers. LPA stated the purpose of the visit was to conduct an annual inspection. Staff confirmed there are two residents living at the facility. The facility is licensed for five residents of which are three non-ambulatory and two ambulatory residents.. Staff called the Administrator and the Administrator arrived at 9:20 am. LPAs toured the facility with the Administrator at 9:30 am until 10:30 am Common Areas – LPA observed the living room contained seating. The dining room contained dining room table and chairs.. Kitchen – LPAs observed the knives were locked in a kitchen cabinet. The medications and first aid kit were locked in a kitchen cabinet. LPAs observed a two-day supply of perishable foods and a seven day supply of non-perishable foods. When observing the refrigerator content, LPAs observed food containers which did not contain lids. Resident Bedrooms - There are three resident bedrooms which are furnished with a bed, linens, night stand, chest of drawers and a closet. Bathroom - There are two bathrooms located in the facility. LPA Spaeth tested the water temperature in bathroom one at 9:50 am which was 105.0 degrees F. Both bathrooms contained hand soap, paper towels, trash can, and grab bars. However, the bathrooms did not contain slip resistant mats. Staff Room - LPA observed the staff room which was not locked and contained staff medication. Smoke/Carbon Monoxide Detectors – The detectors were tested at 10:15 am and observed were operable. Backyard -LPAs observed several gardening tools in the backyard. LPA Spaeth expressed a concern regarding the number of flies and ants that were attracted to the animal excrement. The Administrator stated will clean up the area. Garage - LPA observed the garage was locked and contained washer, dryer, emergency food, and emergency water. Delayed Egress Devices – LPAs observed all delayed egress devices were functional. . LPAs reviewed residents' and staffs' records at 10:30 am until 10:45 am. LPAs observed a facility needs assessment had not been completed for resident (R1). LPA also observed the staff have not completed the yearly required training. Residents’ medications were reviewed at 11:50 am until 12:00 pm. LPAs did not observe any issues. LPAs observed the two caregivers had difficulty ambulating within the facility. The requirement that all personnel shall be physically capable of performing assigned tasks was not met. Pursuant to Title 22 Division 6 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D). Exit interview conducted, Appeal Rights discussed, and a copy of the signed report was given to caregiver