Routine inspection·July 24, 2025

On 07/24/2025, the California Department of Social Services (CDSS) – Community Care Licensing Division (CCLD) staff conducted an unannounced Required – 1 Year Inspection to the above-named facility and met with Administrator, Bryan Bernardino. CCLD staff explained the purpose of the visit and was accompanied by a staff member inside and outside the facility during this inspection. This facility is licensed to serve 6 bedridden adults ages 60 and above. The facility has an approved hospice waiver for 6 residents. A total of 5 residents are currently residing in this facility. The Annual Licensing Fees are current. Facility Layout: The facility is a one-story house located in a residential street. The home consists of 6 resident bedrooms, 1 staff bedroom, 4 full bathrooms, 1 kitchen, 1 dinning room area, 1 living room area, 1 attached garage, 1 front yard patio area, 1 backyard patio area with shaded seating. Outside Grounds: were toured no bodies of water were observed, walkways around the home were clear of hazards, and there are no security bars or weapons on the premises. Kitchen Area/Facility Food: The facility has 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 inaccessible to residents in care. There is a fire extinguisher in the kitchen area, and it was last serviced on 04/14/2025. There is a landline phone in the kitchen. Living Room: There are games/activity work (i.e. board games and books) for residents in the living room area. There are couches and chairs for residents to sit at. Resident Bedrooms: 5 out of 6 resident bedrooms were toured. There is adequate lighting, plenty of dresser and closet space observed. Walls and floors were clean and in good condition. Bathrooms: Toilets, showers, and water faucets worked properly, grab bars were secure, and a non-skid mat was in place. Adequate lighting and toiletries are accessible to residents. The hot water temperature measured between 102 Fahrenheit to 110 Fahrenheit. Medications: were inaccessible to residents in care. All medications observed were labeled and maintained in compliance with label instructions and State and Federal law. 5 out of 5 resident Medication Administration Records (MARs) were reviewed and they were current and up to date. Garage: is used as a storage room and extra facility food and supplies are kept in the garage. Miscellaneous: Documents are posted as mandated. Last fire drill was conducted on 07/2025. The first aid kit is fully stocked with manual. Smoke and carbon monoxide detectors were in compliance and operational. There is a videoconferencing device in the facility for resident use. 5 staff records were reviewed, 5 out of 5 staff records have required criminal record clearance. 2 out of 5 staff records were not complete and current by not having the health screening report, training's, and current first aid certificate. 5 resident records were reviewed, 3 out of 5 resident records were not complete and current. Resident 2 did not have: Physicians Report, Preplacement Appraisal Information, Tuberculosis Test Results, Personal Rights, and Safeguards for Property/Valuables. Resident 3 and Resident 4 did not have an updated Appraisal within the 12 months. A technical violation is being provided regarding maintaining complete and current staff records in the facility. A deficiency is being cited based on record review in accordance with the California Code of Regulations, Title 22, see LIC809D. A violation regarding maintaining complete and current resident records in the facility. 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 Administrator, Bryan Bernardino.