Routine inspection·February 22, 2024

On 2/22/2024, Licensing Program Analyst (LPA) Alfonso Iniguez conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Candice Michelson/Administrator. LPA explained the purpose of today’s visit. Facility is licensed for (6) non-ambulatory residents and (1) bedridden residents. The facility has an approved hospice waiver for (1) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: 3 bedrooms, 2 bathrooms, family room/dining room, kitchen, living room, shaded area, indoor and outdoor activity area, laundry room and detached garage. LPA Iniguez toured the physical plant with caregiver. There were no bodies of water or obstructions on the premises. A total of (3) 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 condition. The water temperature did not properly measure between: 105°F-120°F: Kitchen 127.0°F, Bathroom #1:125.0°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. Sharps objects and cleaning agents were locked and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available at the property. All fire extinguishers were charged and were operable. A review of (2) resident records and (2) staff records were conducted. LPA checked (2) Medication Administration Records (MAR) and no discrepancies were found. The first AID kit was checked. The last facility disaster drill was: 12/12/2023. LPA observed the facility's infection control practices. A copy of the liability insurance will be emailed to LPA. Facility annual fee current. Deficiency cited under California Code of Regulations, Title 22, Division 6, Chapter 8. See details below: -Water temperature above 120F.(kitchen sink and restroom #1). -No health screening and TB test on file for S#1 - No medical assessment and TB test on file for R#2. -No appraisal and SPV form for R#1. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Candice Michaelson/Administrator.