Routine inspection·January 17, 2024

On 1/17/2024, Licensing Program Analyst (LPA) Alfonso Iniguez conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Ceceni Rose Pare/Administrator. LPA explained the purpose of today’s visit. The facility is licensed to serve (6) residents ages 60 and above ambulatory/non-ambulatory. Dementia waiver on file. Approved hospice waiver for (2). The facility is a single-story structure located in a residential neighborhood. It consists of (5) resident bedrooms, (1) staff room, (2) full bathrooms, kitchen, dining area, living room, and patio area with shade located in backyard. The facility entrance and exits are wheelchair accessible. The facility has (1) garage that is utilized for supplies. LPA Iniguez toured the physical plant with administrator. There were no bodies of water or obstructions on the premises. A total of (5) rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, and storage for the resident’s personal belongings was observed. Bathrooms were found to be within Title 22 regulations and were operational. LPA inspected the carbon monoxide detectors combo were in operable conditions. The water temperature properly measured between 105°-120°F: Kitchen 109.7°F, Bathroom #1:112.7°F, Bathroom #2:109°F. Evaluation Report Continues LIC 809-C LPA Iniguez observed the facility to be clean, sanitary, and appropriately furnished at the time of the visit. Storage areas for personal hygiene, sharps objects were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. All fire extinguishers were charged and were operable. A review of (3) residents' service files, (2) staff personnel files and (3) Medication Administration Records (MAR) LPA did not find discrepancies. The first AID kit was checked. Last facility disaster drill was: 12/11/23. LPA observed the facility's infection control practices. A copy of the liability insurance will be emailed to LPA. Deficiency cited under California Code of Regulations, Title 22, Division 6, Chapter 8. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Ceceni Rose Pare /Administrator.