Routine inspection·April 22, 2025

Licensing Program Analyst (LPA) Mayra Cota conducted an unannounced required annual visit. LPA met with Belma Fernandez, Caregiver, and explained the reason for the visit. Administrator, Maria Tavarez, arrived thereafter and assisted with the visit. The facility is licensed to serve 4 non-ambulatory elderly residents, ages 60 and over, with a Hospice waiver for 2 residents. The facility is operating within the scope of its license. Clients receive services through the Harbor Regional Center. The facility is a single-story home located in a residential area of Lakewood, CA. LPA and Administrator toured the home and inspected the living room, dining area, kitchen, 4 resident bedrooms, 2 resident bathrooms, 1 staff bedroom with private bathroom, laundry area, attached garage, front yard and back yard. During today’s visit, LPA observed the following: Inside the home: Living room and dining area are clean and furniture is in good repair. Both areas have enough seating for residents. A fireplace was observed and is covered appropriately. Kitchen counter tops and meal preparation surfaces were observed clean and free of clutter. Kitchen appliances were observed in operable condition during time of visit. ***Continues on LIC 809-C Sharps/knives are kept locked in a kitchen cabinet. Cleaning supplies and toxins are also kept locked and inaccessible to residents in care. Sufficient supply of 2 day perishable and 7 day non-perishable food was observed and additional food is kept in an overflow refrigerator in the garage.. Several dry and canned food items were observed to be kept beyond the "best if used by" date in the kitchen pantry. Dry food containers were observed without an expiration label in the pantry. Client bedrooms have the required furniture such as bed frames, dressers, lamps, and chairs. Bedrooms also have sufficient closet space. Client beds have the required linen and mattress pads. Extra resident mattress pads, bed linen, absorbency pads (Chux), and towels are kept in a closet. Resident bathrooms were inspected and were observed clean. Safety mats were observed and showers are equipped with safety grab bars. The water temperature was tested in both resident bathrooms and measured at 109.2 degrees F in bathroom 1- and 109.5 degrees F in bathroom 2 which is within the required 105 - 120 degrees F. Personal hygiene products are readily available for residents in care. Outdoor environment: The front and backyard are well maintained and there are no pools or large bodies of water. There is a shaded seating area accessible to clients, located in the backyard. Passageways and exits are free of obstruction. Attached garage was inspected and is used for storage. Garden area is well maintained and gardening tools were observed locked at the time of visit. Medication and Record Review : Resident medications are centrally stored and locked in medication cabinet. Medication was observed to be administered per physician's orders and documented accordingly on MAR logs. Four resident and five staff records were reviewed. Records reviewed have all required documents. ***Continues in LIC 809-C Disaster Preparedness: Combination smoke and carbon monoxide detectors were observed throughout the facility and were tested and working properly at the time of visit. Two fire extinguishers were inspected and were observed charged. Both were last serviced on 3/5/25. Extra emergency supplies like a flashlight and a food supply are kept in the garage. Facility is equipped with a backup generator. First Aid kit and manual are kept readily available for use. Ramps and stair cases are free of obstructions. A Technical Advisory is being issued and a Deficiency is being cited (See LIC 809-D) per California Code of Regulations, Title 22, and California Health and Safety Code Exit interview was conducted with the Assistant Maria Tavarez. A copy of the report, appeal rights was issued.