Routine inspection·October 18, 2024

Licensing Program Analyst (LPA) Christian Gutierrez conducted the annual inspection using the Compliance and Regulatory Enforcement (CARE) tools. LPA met Care Giver Correa Tan at approximately 12:00 PM and explained reason for visit. Administrator was notified by phone. The facility is a single-story home, operating as a Residential Care Facility for the Elderly. It is licensed to serve (6) older adults, ages 60 and over. There is a fire clearance approved for (6) non-ambulatory residents. It has an approved Dementia Care Plan and a Hospice Waiver approved for (6) residents. The home consists of 3 shared resident bedrooms, 3 bathrooms, a kitchen, dining room, living room, TV room, a shaded patio in the backyard and an attached garage. LPA toured the facility and observed the following: Each client bedroom has the required furniture and bedding. There is extra clean linen and towels in a hallway closet. Smoke detectors/carbon monoxide devises were observed in each room and throughout the facility and are properly operating. The facility has three (3) fully charged fire extinguishers which is kept in the kitchen, hall and garage. Cleaning supplies and toxic substances were observed to be accessible to clients in bathroom #1 under sinks deficiency cited. Freezers are maintained at a temperature of 0-degree F and the refrigerators at a maximum of 40 degrees F. Sufficient supply of 2 days perishable & 7 days non-perishable foods was observed in the kitchen. Sharps are locked and placed in cabinet in kitchen. There are no firearms or weapons stored at the facility. The hot water temperature in the bathrooms were measured between the required range of 105-120 degrees F. The shower accommodates non-ambulatory residents and has the required grab-bars and non-skid mat. The facility does not have a swimming pool or bodies of water on the premises There is a shaded seating area for the residents located in the backyard. Passageways and exits are free of obstruction. The garage is clean and has extra supplies and food. SEE LIC 809 C Four (4) Staff files were reviewed and included Criminal clearance record, CPR/training, and health screening with TB. Six (6) Client files were reviewed and included physicians report, TB clearance. Fire/earthquake drill was conducted in October of 2024. Infectious control plan was reviewed. The medications are centrally stored and locked in a cabinet in dining room. The facility uses the Medication Mar Log. LPA reviewed medications for three (3) clients, and they are being administered as prescribed by the physician. Deficiencies have been noted on LIC 809D under Title 22 Regulations. Exit interview was conducted and a copy of this report, LIC 809D and appeal rights were provided.