Routine inspection·April 8, 2025

At 9:30am, Licensing Program Analysts (LPAs) Angela Panushkina and Huma Rahimi arrived at the facility to conduct an unannounced annual inspection. Upon arrival, LPAs met with the Administrator and explained the reason for the visit. At 9:40am LPAs conducted a physical plant tour and observed the following: Facility is licensed for capacity of six (6) Non-Ambulatory of which one (1) may be Bedridden in room #1 or #2. Hospice waiver for four (4) residents is also approved. LPA observed there to be sufficient stock of one-week perishable foods and two-day non-perishable foods. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. All knives were observed to be locked in the kitchen drawer. The fire extinguisher is located in the kitchen area and was last serviced on 01/24/2025. Facility maintains a temperature of 72°F. Medications, resident/staff files were kept in the kitchen cabinet and observed to be locked and inaccessible to residents in care. There is a complete first-aid kit in the cabinet with all required supplies and with the first aid manual. There are four (4) bedrooms designated for residents’ use, and three (3) bathrooms. Facility has an awake staff. Bedrooms are appropriately furnished and have appropriate lighting. Bathrooms have soap, paper towels and all trash cans have a lid. Extra towels and linens were readily available. The hot water temperature measured at 108.5°F. Laundry is located in the hallway. The washer/dryer appear to be in a good condition. Laundry supplies, chemicals and detergents are kept locked in the laundry room and inaccessible to residents in care. Continue on LIC809-C Dual smoke and carbon monoxide detectors were located throughout the facility, and at 10:45am they were tested and observed to be operational. At 10:55am, LPAs observed appropriate outdoor furniture, with a covered shaded area for the residents. LPAs discussed the importance of maintaining the care and supervision to meet the needs of residents. There are no bodies of water. Between 11:00am to 12:00pm, LPAs reviewed records of four (4) residents and two (2) staff, and the following noted: · One (1) out of four (4) residents had full bed rails however, no doctor's order was available. Per Administrator, Resident #1 (R1) was on hospice for a long period of time and due to the insurance not covering the hospice services the agency had to discharge R1. LPAs were informed that on 04/10/25, R1 will be admitted back on hospice and start receiving services again. LPAs explained that full bed rails are not permitted unless a resident is on hospice and if resident/family insists an exception can be submitted to CCL with all required documents. LPAs collected Certificate of Liability Insurance and LIC500. Pursuant to Title 22 CA Code of Regulations, the following deficiency was cited on LIC809-D Exit interview conducted. Appeal rights explained and a copy of this report signed and delivered.