Routine inspection·June 29, 2024

On 06/29/24 at 9:13 AM, Licensing Program Analyst (LPA) Regina Cloyd conducted an unannounced required – annual inspection and met with Staff and Licensee Angelique Gradney. The facility is licensed to serve six (6) non-ambulatory residents, of which one (1) may be bedridden. The facility has a hospice waiver approved for six (6) residents. The facility consists of four (4) resident bedrooms, three (3) bathrooms, kitchen, living room, dining area, office area, staff bedroom adjacent to the living room, and shaded patio. The facility is clean, sanitary, and in good repair. Staff accompanied LPA inside and outside the facility during this inspection. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. Residents' bedrooms had the required bed linens and closet/drawer space to accommodate each resident comfortably. There are no security bars or weapons on the premises. Beds and bedding were in good condition, adequate lighting provided, and walls and floors were in good repair. Residents' bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place, hot water temperature measured at 124 F and a hot water temperature warning sign was prominently placed. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards, doorways were free of obstructions. LPA toured the kitchen area and observed a two-day supply of perishable and a seven-day supply of non-perishable food. Knives and toxics were kept in locked storage cabinet. First Aid kit was available. One fire extinguisher, last serviced August 2023 was observed in the kitchen area. Continue to LIC809-C. Licensee tested the carbon monoxide detector and smoke detectors in the house. Both devices were functional. Four (4) staff records were reviewed, 4 out of 4 staff records had required criminal record clearances or criminal record exemptions. Five (5) resident records were reviewed and, 5 out of 5 resident records had medical assessments and pre-appraisal. Two residents’ medication was reviewed. Deficiency was observed (see LIC809D) and cited from the California Code of Regulations, Title 22. Based on observation and record review, staff gave expired medication to a resident. An exit interview was conducted, plans of correction developed and reviewed, and a copy of this report and the appeals rights was discussed and left with the Licensee Angelique Gradney.