Routine inspection·February 28, 2025

At 9:50a.m., Licensing Program Analyst (LPA) Antonia Alvizar-Ettima conducted an unannounced Required One (1) year inspection to the facility. LPA met with Reliever and granted entry in the facility. At 10:00 a.m., Administrator arrived and explained the reason for the visit. At 10:30a.m. LPA and Administrator conducted a tour of the physical plant. There is one entrance being utilized at the facility. Facility is a single-story residence located in a residential neighborhood. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: The facility has a total of five (05) bedrooms and four (04) bathrooms. The facility is fire cleared for six (06) non-ambulatory and a hospice waiver for four (04). The facility is currently occupying seven (07) residents. Last fire drill was conducted on 01/19/2024. The living and dining room are neat and clean. The facility maintains a comfortable temperature at 75°F. The smoke and carbon monoxide detectors are hardwired, interconnected and observed to be operational. Fire extinguisher is located near the kitchen, observed to be full and last purchased on 03/02/2024. Kitchen is sufficiently stocked with at least two (02) days perishable and seven (07) days non-perishable food. Frozen foods are wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. Knives and sharps are observed to be locked and inaccessible to residents. Residents rooms are adequately furnished with appropriate lighting system. Hallways are well lit. Residents have enough personal hygiene product provided by the licensee. Cont. on LIC 809-C The bathroom was checked for cleanliness and proper operations. The hot water temperature was measured at 115.4°F. Towels and washcloths are not shared. There was enough clean linen available in the cabinets. The facility has outdoor furniture with a covered shaded area for residents and visitors. The facility has a swimming pool with appropriate locked fence. The shed is currently being used for storage. Laundry detergents, cleaning agents and other toxins are locked away. LPA observed medication and first aid kit to be locked and inaccessible to residents. A file review of resident records to ensure compliance of licensing forms. A file review of staff records to ensure forms and training are up to date and compliance with licensing forms. Pursuant to Title 22 Division 6 of the CA Code of Regulations, deficiencies observed cited on LIC809-D during the visit. Exit Interview Conducted / A Copy of the Report was provided to Administrator.