Routine inspection·April 30, 2024

On 4/30/2024, Licensing Program Analyst (LPA) Alfonso Iniguez conducted an unannounced annual required using the CARE Inspection Tool. LPA met with Evangeline Agatep /Licensee. LPA explained the purpose of today’s visit. The facility is licensed to serve (6) elderly adults ages 60 and above of which (6) can be non-ambulatory and (1) bedridden in bedroom #3 only. Facility has an approved hospice waiver for (2). The facility is a single-story structure located in a residential neighborhood. It consists of (3) bedrooms, (2) full bathrooms, shaded back yard, front yard, laundry room in the attached 2 car garage. LPA Iniguez toured the physical plant with Executive Director. 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 residents’ personal belongings was observed. Bathrooms were found to be within Title 22 regulations and were operational. LPA inspected (3) rooms and (2) bathrooms. Smoke and carbon monoxide are all operable conditions. The water temperature ranged from 113.5F° – 115.2F°. The room temperature ranged from 76F° – 78F°. Evaluation Report continues on LIC 809-C LPA Iniguez observed the facility to be sanitary and appropriately furnished at the time of the visit. Storage areas for personal hygiene were observed. Cleaning supplies, toxins, and sharps objects were stored and not accessible to residents in care. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. All fire extinguishers were charged and were operable. The last Fire/Disaster Drills were conducted on 4/10/24. A review of (3) residents' service files and (3) staff personnel files were maintained in order. LPA reviewed (3) Medication Administration Records (MARs) discrepancies were found. LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. All mandated inspection control posters were posted throughout the facility. Facility Annual Fess not current as 4/6/24. LPA provided PIN: 418679 to licensee. Licensee stated she will pay them later today. Deficiency cited under California Code of Regulations, Title 22, Division 6, Chapter 8. See details below: -Facility staff did not documented medication given for R#1, R#2, and R#3 on MARs April 2024. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Evangeline Agatep /Licensee.