Routine inspection·June 20, 2025

Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced required annual visit and was greeted by two staff members. The Licensee, Mary Ann De Lima arrived at 10:40 am. The facility is licensed to serve six residents of which six may be non-ambulatory and one may be bedridden in any of the bedrooms and there is a hospice waiver for six. LPA Spaeth reviewed the residents files at 10:30 am until 11:30 am. LPA reviewed staff files at 11:45 am until 12:15 pm. LPA observed two staff members' CPR/First Aid training had expired. LPA Spaeth and the Administrator toured the facility at 12:00 pm until 12:30 pm. LPA Spaeth observed the facility was neat and clean. Kitchen – LPA observed a seven-day supply of non-perishable food and a two day supply of perishable food items. LPA observed the cleaning supplies were securely locked underneath the kitchen sink and the knives were locked in a kitchen drawer. The medications are locked in a kitchen cabinet and LPA also observed the first aid kit. A fire extinguisher is also located in the kitchen area. Continued on 809-C Backyard – LPA Spaeth observed the delayed egress alarm leading out of the sliding glass door to the backyard was properly working. The backyard is a shaded area which contained comfortable seating. The side gate leading from the backyard to the front yard was not locked. Bedrooms – LPA Spaeth observed there is one resident living in the master bedroom. The delayed egress alarm leading from the bedroom to the backyard was properly working. The room contained bed, linens, night stand, and night lamp. LPA also observed the other three bedrooms were finished. Water Temperature - The water temperature was tested at 12:05 pm and was 105 degrees F. Bathrooms – LPA Spaeth observed both bathrooms contained slip resistant mats, hand soap, paper towels, grab bars, and trash can. Common Areas – LPA observed comfortable seating in the living room and family room. The dining area contained a dining room table and chairs. Smoke/Carbon Monoxide Detectors -The smoke/carbon monoxide detector was tested at 12:30 pm and was operable. Pursuant to Title 22, California Code of Regulations, one deficiency will be cited (refer to LIC 9099-D. Exit interview conducted, appeal rights discussed, and a copy of the report was given.