Routine inspection·August 9, 2024

On 08/09/2024 at around 8:00 AM, Licensing Program Analyst (LPA) Leandro conducted an unannounced Required – 1 Year Inspection to the above-named facility and met with the Caregiver Jeremy Jade Ebilane Nebres. LPA explained the purpose of the visit and was accompanied by Caregiver inside and outside the facility during this inspection. This facility is licensed to serve 6 non-ambulatory adults ages 55 and above, of which 2 may be bedridden. A total of 5 residents are currently residing in this facility. The Annual Licensing Fees are current. The facility is a one-story house located in a residential street. The home consists of 5 resident bedrooms, 1 staff room, 3 bathrooms, 1 living/dining/office/kitchen area, 1 attached garage, and 1 backyard patio area with shaded seating. Outside grounds were toured and no bodies of water were observed. The patio furniture is under a shaded area and accessible to residents. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises. LPA toured the kitchen area and observed supplies of nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days. Knives and toxins were kept in locked storage cabinet. LPA observed that medications were safe, locked, and inaccessible. All medications observed were labeled and maintained in compliance with label instructions and State and Federal law. Documents are posted as mandated. Last Fire drill was conducted on 06/15/2024. First aid kit is fully stocked with manual. Smoke and carbon monoxide detectors were in compliance and operational. There is a fire extinguisher in the kitchen area and it was last serviced on 02/19/2024. The facility does not have a videoconferencing device dedicated for resident use. LPA observed liability insurance expired on 06/23/2023. LPA observed: mold in bathroom 1, bedroom 2’s drawer in disrepair, kitchen cabinet in disrepair, no shower head in bathroom 3. 4 out of 4 resident’s bedrooms were checked. Mattresses were in good condition, adequate lighting, plenty of dresser and closet space observed. Walls and floors were clean and in good condition. Comforters, bed linen, bath towels and mattress protectors were adequately stocked. Bathroom toilets and water faucets worked properly, grab bars were secure, and a non-skid mat was in place. Adequate lighting and toiletries accessible to residents. LPA tested hot water temperature and it measured between 105 and 120 degrees Fahrenheit. This facility provides residents with hygiene products such as feminine napkins, nonmedicated soap, toilet paper, toothbrush, toothpaste, and comb. 5 staff records were reviewed, 5 out of 5 staff records had required documentation. 5 resident records were reviewed and, 5 out of 5 resident records had required documentation. Deficiencies are being cited based on LPA observation and record review in accordance with the California Code of Regulations, Title 22, see LIC809Ds. Violations regarding: facility in good repair; videoconferencing device dedicated for client use; liability insurance; Resident 5 medication assistance. An exit interview was conducted, Plans of Corrections were reviewed and developed. A copy of this report and appeal rights were discussed and left with the Caregiver.