Routine inspection·September 26, 2024

At 9:30 AM, Licensing Program Analyst (LPA) Huma Rahimi conducted an unannounced annual visit. LPA met with the House Manager, Stephen Parks and LPA disclosed the reason for the visit. LPA and the House Manager toured the facility inside and out. It is a single story building with five (5) bedrooms, three (3) bathrooms, kitchen, garage, common areas, and outdoor areas. It has an approved fire clearance for six (6) residents, of which six (6) may be bedridden. Approved hospice waivers for six (6). Additionally, LPA observed an ADU unit with the address of 7628 Wilbur Avenue, Reseda, CA 91335, built in the property. LPA was not provided an access to the property since it was locked. Administrator informed LPA that the unit is vacant and no individuals residing at the unit. Kitchen: At approximately, 9:45 AM LPA toured the kitchen area and observed enough supplies of staple non-perishable for minimum 1 week and perishable for 2 days at the facility. All knives and sharps observed to be locked in a kitchen drawer. LPA observed a fully charged fire extinguisher hung in the kitchen purchased on 08/30/2024. A laundry area near the kitchen contained an operable washer and dryer. Cleaning solutions were locked near the appliances. Medications: At approximately, 9:50 AM LPA observed medications are centrally stored and locked in a moveable locked cabinet located in an office area near the main entrance. LPA did not observe a Centrally Stored Medication and Destruction Record (CSDMR/LIC 622) for five (5) out of five (5) residents. Review of R1’s medication revealed that the facility was supposed to start Ezetimibe 10 MG (High Cholesterol Medication) a new bottle on 08/15/2024. During today's visit LPA counted R1's medication and it was discovered that there was a discrepancy, and sixteen (16) extra pills were in the bottle. LPA asked the Administrator for explaining and the Administrator stated that they might have extra pills from an old bottle that was administered; however, due to the lack of documentation of Centrally Stored Medication Record (LIC 622), LPA could not verify the information with new bottle start date. A deficiency will be cited. Continue on LIC809-C Garage: LPA observed the garage locked and contained extra food, a second refrigerator, PPE, incontinence supplies, and assistive devices. Bedrooms: The facility had five (5) bedrooms. Three (3) were private and two (2) were shared. All bedrooms contained a chair, nightstand, lamp, storage, and bed with adequate bedding. All furnishings were clean and in good condition. Facility has awake staff. Bathrooms: LPA observed three (3) bathrooms and all bathrooms appeared to be clean and in good repair. Properly supplied with toilet papers, soap and paper towels. LPA observed appropriate grab bar and client's bathroom had non-skid mat. LPA observed appropriate hand washing signs posted in each bathroom. At 9:55 AM, hot water temperature measured at 113°F. Common Areas : The facility maintains a comfortable temperature at 75°F. The living room and dining area appeared clean and were properly furnished. The living room has a television, comfortable furniture. No obstructions and or tripping hazards throughout the facility. Smoke detectors/carbon monoxide . At 10:05 AM, LPA tested the dual-purpose smoke and carbon monoxide detector to be operational. All detectors were hard-wired, and the facility uses fire sprinklers. All auditory alarms were on, functioning, and centrally wired. Outside areas: At approximately, 10:20 AM LPA toured the outside area of the facility. LPA observed appropriate outdoor furniture, with a covered shaded area for residents. The emergency exit path was unlocked and free from debris. Between 11:15 AM to 12:45 PM, LPA reviewed records of five (5) residents and two (2) staff. Residents and staff records appeared to be complete and updated. LPA determined that a Case Management visit regarding an ADU permit verification will be conducted on another day. Administrative: LPA collected Certificate of Liability Insurance, and LIC500. A deficiency cited during today’s visit. Appeal Rights explained. Exit interview conducted and copy of this report signed and delivered.