Routine inspection·March 26, 2024

On 3/26/2024, Licensing Program Analyst (LPA) Alfonso Iniguez conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Antonia Dionisio/Administrator. LPA explained the purpose of today’s visit. The facility is licensed to serve (6) residents ages 60 and above. Of which (6) may be non-ambulatory. Approved hospice waiver for (1) in bedroom #3. The facility is a single-story structure located in a residential neighborhood. It consists of the following: four (4) resident's rooms, two (2) bathrooms, two (2) living areas, dining area, laundry room, and kitchen. LPA toured the physical plant with staff. There were no bodies of water or obstructions on the premises. A total of (4) rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, and storage for the resident’s personal belongings was observed. Bathrooms were found to be within Title 22 regulations and were operational. LPA inspected the carbon monoxide detectors combo were in operable conditions. The water temperature properly measured :Kitchen 110.6°F, Bathroom #1:107.2°F and Bathroom #2:106.4°F. Evaluation Report Continues LIC 809-C LPA Iniguez observed the facility to be clean, sanitary, and appropriately furnished at the time of the visit. Storage areas for personal hygiene were observed, cleaning agents, poisons, and sharps objects were locked and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. All fire extinguishers were charged and were operable. A review of (3) residents' service files, (2) staff personnel files were checked. (3) Medication Administration Records (MAR) were reviewed discrepancies were found . First AID kit was checked. Last fire disaster drill was on:3/4/2024. LPA observed the facility's infection control practices. Liability insurance will be emailed to LPA. Facility Annual Fees Not Current . LPA gave to administrator PIN#602495 to pay fees online as soon as possible. Deficiency cited under California Code of Regulations, Title 22, Division 6, Chapter 8. See details below: -Documentation error on MARS for R#1. -Expired CPR card for S#2. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Antonia Dionisio/Administrator.