Routine inspection·December 12, 2022

On 12/12/2022, Licensing Program Analyst (LPA) Lourdes Montoya conducted an unannounced annual required visit with a primary focus on Infection Control measures using the new CARE Inspection Tool. LPA Montoya conducted a risk assessment with Licensee/Administrator Glenda Bustos who confirmed the facility is free of Covid-19 infection. LPA met with two caregivers (S1 and S2) and explained the purpose of today’s visit. House Manager Melanie Tallada later joined the visit. The facility is licensed to operate for six (6) elderly residents ages 60 and above. The facility is approved for six (6) non ambulatory of which one (1) may be bedridden and two (2) can be under hospice care. The facility is a single-story structure located in a residential neighborhood. The facility consists of the following: five (5) resident bedrooms, three (3) bathrooms of which one (1) is designated for staff only, a living room area, a dining area, kitchen, receiving or visitation room and an attached garage used for storage only. The washer and dryer are stacked and located in the kitchen and there is a second refrigerator/freezer in the garage. LPA and House Manager Melanie Tallada toured the inside and outside grounds of the physical plant. There are no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting provided, storage for resident personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were clean and operational. A comfortable temperature was maintained in the facility. Evaluation Report Continues on LIC 809-C. LPA observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, and toxins were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. There are two (2) fire extinguishers fully charged in the kitchen and the garage. First aid kit was located in the kitchen. Smoke detectors and carbon monoxide were operable. During the visit, LPA observed the facility infection control practices. LPA observed screening protocols for visitors, staff, and residents, sanitizing stations in common areas and restrooms. LPA observed six (6) residents and two (2) staff present during the tour. All mandated inspection control posters were posted. Advisory Note was issued, please see LIC9102-AN. LPA reminded the House Manager and the licensee (via phone) that the facility annual fees are not current. LPA provided the House Manager a copy of LIS printout showing the balance due and a PIN number. LPA also advised House Manager Tallada that the administrator's certificate has expired on 6/19/2021. Tallada stated the administrator has already filed the renewal and waiting for the certificate. Three deficiencies were cited during this inspection visit. See 9099-D page. An exit interview was conducted, and a copy of this report was provided to House Manager Melanie Tallada.