Routine inspection·April 19, 2024

On 04/19/24 at 12:20 PM, Licensing Program Analyst (LPA) Regina Cloyd conducted an unannounced required – annual inspection and met with Licensee Myrna Ma . The facility is licensed to serve six (6) residents, all of which (6) may be non-ambulatory with a hospice waiver approved for four (4) aged 60+ years. The one-story residential home consists of four (4) resident bedrooms, one (1) resident bathrooms, living room, dining room, family room, kitchen, office area, attached garage with washer and dryer/ storage area, backyard with table and chairs. The facility is clean, sanitary, and in good repair. Licensee accompanied LPA inside and outside the facility during this inspection. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. There are no security bars or weapons on the premises. Resident bathroom were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place, hot water temperature properly measured between 109.5F. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards, doorways were free of obstructions. Knives and toxics were kept in locked storage cabinet. First Aid kit was available. Two fire extinguishers was observed in the kitchen area. Staff tested the carbon monoxide detector and smoke detectors in the house. Both devices were functional. Continue to LIC809-C. 5 staff records were reviewed, 5 out of 5 staff records had required criminal record clearances or criminal record exemptions. Two staff interviews were conducted. 4 resident records were reviewed and, 4 out of 4 client records had medical assessments. Two residents’ medication was reviewed. Two residents were interviewed. Deficiencies are being cited based on record review in accordance with the California Code of Regulations, Title 22, see LIC809D. LPA Cloyd did not observe Health Screening Reports (LIC 503) for Staff #1 and Staff #5. Staff #1 was on site. An exit interview was conducted, technical assistance provided, Plans of Corrections were reviewed and developed with the Administrator. A copy of this report and appeal rights were discussed and left with Caregiver Arturo Yangco.