Routine inspection·August 27, 2024

Licensing Program Analyst (LPA) Cynthia Chan conducted the annual inspection on 8/27/24. LPA arrived unannounced and met with Staff, Cherry Serame. The purpose for the visit was explained. Administrator, Trupti Mody, arrived shortly after to assist with the visit. The facility is licensed to serve (4) residents ages 60 and over, of which 3 may be non-ambulatory and 1 bedridden. Bedridden is approved in master bedroom #1. There is an approved hospice waiver for 4 residents. The facility is vendored by the San Gabriel/Pomona Regional Center. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools to inspect the facility. The single story facility consists a total of 7 bedrooms. However, the facility is only using the bedrooms to the right of the house for residents, which 3 bedrooms are for residents, 1 for staff, and 2 bathrooms. The other side of the house consists of 3 bedrooms dedicated as staff rooms and 1 bathroom. There is also a living room, dining room, kitchen, laundry room, and attached garage. Food supplies are adequate. The fireplace is not in use and is secured by a fence. There are no swimming pool or bodies of water on the premises. Facility has a smoke detector in each room and 2 carbon monoxide detectors at the home. Knives, cleaning solutions, and disinfectants are locked. The hot water temperature was measured between the required range of 105-120 degrees F. Staff are continuing to follow their infection control plan and wearing gloves while assisting residents. LPA reviewed 2 personnel files. The administrator's (Trupti Mody) certificate has expired but verified that the renewal documents have been received. Staff have the required documents and training hours in their files. Staff have current CPR & First aid certificates. LPA reviewed 2 Resident files and they also have the required documents. The Complaint poster, Local Ombudsman, and Residents personal rights are posted. Facility has sufficient space to accommodate indoor and outdoor activities. Medications are centrally stored in the kitchen cabinet. LPA reviewed 2 resident medications and are being administered as prescribed. The facility has the Emergency Disaster Plan with contact numbers, at least 2 relocation sites, and procedures in case of emergency. There are no deficiencies issued today. An exit interview was held and a copy of this report was given to administrator Trupti.