Routine inspection·March 28, 2025

Licensing Program Analyst (LPA) Angela Barutyan arrived at the facility unannounced to conduct a required annual visit at 09:55AM. Upon arrival, LPA met with staff and Administrator Assistant (AA) Irina Fried. Entrance interview conducted. At 09:56AM, the LPA along with the AA, toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. BEDROOMS: There are six (6) private resident bedrooms. LPA observed resident bedrooms to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. RESTROOMS: There are three (3) restrooms. Restrooms were clean and sanitary and in operating condition with grab bars and slip-resistant surfaces. The restrooms were sufficiently stocked with supplies and paper towels; towels and washcloths are not shared. At 10AM, hot water in the shared bathroom between bedrooms #6 and #5 measured at 83.3 degrees F, which is not within the required range of 105-120 degrees F. At 10:02AM, hot water in bedroom #3’s bathroom measured at 134.4 degrees F. At 10:15AM, hallway bathroom by bedroom #1 measured at 146.1 degrees F. AA immediately lowered the water heater settings for both water heater tanks. AA stated that the shared bathroom between bedrooms #6 and #5 has hot water, but it takes a while to heat. AA stated they will monitor the hot water in bathrooms and will send a temperature log to LPA. LPA retested hot water in the hallway bathroom at 11:15AM and it measured at 138.9 degrees F. AA stated that it will take about 12 hours for the water heater settings to adjust to the change. Report Continued on LIC 809-C KITCHEN/GARAGE: The LPA inspected the kitchen/food service area at 10:16AM. Kitchen appliances appeared clean and were in operable condition at the time of the visit. The facility has a sufficient supply of perishable and nonperishable food. Food labels were inspected and checked for expiration dates and food labels had expiration date clearly marked. Knives and chemicals were locked inaccessible in kitchen drawer and under-the-sink cabinet. Fire extinguisher was fully charged and last serviced 05/16/2024. The attached garage is kept locked and inaccessible and contains an additional refrigerator/freezer, laundry area, nonperishable food, and additional supplies. COMMON AREAS: At the time of the visit, living room and dining area furniture were observed to be in good condition. The facility maintained a comfortable temperature of 73 degrees F. At 11:17AM, smoke detector(s) and carbon monoxide detector were tested and were operational at the time of the visit. Auditory exit alarm in the living room was off, AA replaced the batteries during the visit. LPA observed required postings throughout the common spaces. OUTDOOR AREA: LPA observed the back patio which has a covered area for resident use. There is a self-latching gate on the side of the house designated for an emergency exit. Passageways were free and clear from obstruction. There are no bodies of water on the premises. MEDICATION REVIEW: At 10:21AM, LPA reviewed medications for two (2) residents. Medications are centrally stored and locked in the kitchen. All medications including PRNs were labeled, stored, and locked inaccessible to residents. PRNs have physicians order on file. Medications are labeled and checked for expiration dates. Medications are properly documented on the centrally stored medications and destruction record. No errors observed during the medication review. RECORD REVIEW: Beginning at 10:46AM, LPA reviewed three (3) out of three (3) resident files and three (3) out of three (3) personnel files for documents including but not limited to: medical records, care plans, health screening, staff training and fingerprint clearance. All resident and personnel files were in order. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today's visit, LPA reviewed the facility's infection control policy as well as the emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Emergency disaster plan is updated annually as required. No documentation of quarterly emergency drills was provided. The following deficiency was observed (See LIC 809-D.) and cited from the California Code of Regulations, Title 22. Administrator was informed that failure to correct deficiency may result in civil penalties. Exit interview was conducted. A copy of the report and appeal rights were provided.