Routine inspection·January 3, 2024

In conjunction with a Case Management (CM) visit, Licensing Program Analyst (LPA) Michael Cava conducted an Annual Required visit and inspection of the facility. LPA met with staff, James and Susan Olalia, and explained the reason for the visit. At approximately 10:42am, with the assistance of staff, LPA took a tour of the physical plant. Required postings were observed in the entry area. The smoke alarms are interconnected. There are two (2) carbon monoxide detectors, one in the living room and one in the hallway, by resident rooms, that functions properly. The fire extinguisher is located in the kitchen. Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Knives were stored and were inaccessible during the inspection. The laundry area is located by the kitchen. No detergents or toxins were observed accessible. LPA also did not observe any cleaning supplies accessible in the kitchen. Bedrooms: There are four (4) bedrooms designated for residents' use. Room 1 and Room 3 are shared, while room 2 and 4 are private. Room 1 is approved for bedridden. Passageways were free of obstruction during the time of the visit. All bedrooms, in use by residents were were properly furnished with appropriate beddings and linens with sufficient lighting. Bathrooms: There are two (2) bathrooms designated for residents' use. Both bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 114 degrees Fahrenheit. LPA did not observe any cleaning supplies in either bathrooms during the inspection. Common Areas : These included the living room and dining area. The common areas were properly furnished. Floors were clean. Furniture were in good repair. Entry and exits were clear of obstruction. Staff Room/Quarters: Staff quarters is located next to the laundry area by the kitchen. Resident medications and medication records are stored inside staff quarters. There is a bed inside the room for staff to rest in. Staff quarters remains locked at all times. No resident access. Surrounding Grounds : Entry/exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area, both front and back was free of hazards. There is an external gate that leads into the property, that remains unlocked at all times. The garage is detached, and is located at the front of the home. The garage is only used for storage. It is locked at all times. Resident Files : Resident files are stored locked in a kitchen cabinet. LPA conducted a file review of resident records to insure compliance of licensing forms. Staff Files : Staff files are also stored locked in a kitchen cabinet. LPA conducted a file review of staff records to insure forms and training are up to date and compliance with licensing forms. Medications : Medication and Medication Records are kept in staff quarters. Medications were reviewed for proper storage and documentation. Pursuant to Title 22 Division 6 of the CA Code of Regulations, deficiencies were cited (refer to LIC 809-D). Exit Interview Conducted / Appeal Rights Discussed / A Copy of the Report Issued.