Routine inspection·March 6, 2024

On 03/06/2024 at 9:45 AM, Licensing Program Analyst (LPA) Regina Cloyd conducted an unannounced required – Annual Inspection and met with Administrator Dmitry Malyshev. Annual Facility Fees are current. Facility is licensed to serve 6 non-ambulatory residents age 60 and above. One may be bedridden in room 2 only. The facility has a hospice waiver approved for 3. Facility is a single story 4-bedroom, 2 common bathroom, 1 common area, a kitchen, a 2 car de-attached garage used for storage, laundry area, linen closet and a large outdoor shaded patio area. Administrator accompanied LPA inside and outside the facility during this inspection. Outside grounds were toured and no bodies of water were observed. Resident bathrooms 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, and warning signs are prominently identified in the kitchen and in the bathroom. The second shower is under currently under construction. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Knives and toxics were kept in locked storage cabinet. First Aid kit was available. Licensee tested all carbon monoxide detectors and smoke detectors located in the facility. Both devices were functional and interconnected. Deficiencies are being cited based on LPA observation and interviews conducted in accordance with the California Code of Regulations, Title 22, see LIC809D. A violation regarding 87204 Limitations - Capacity and Ambulatory Status. The Administrator rented three of the bedrooms out to private individuals. There are no residents in care. An exit interview was conducted, plans of corrections were developed and reviewed, and technical assistance provided. A copy of this report and appeal rights were discussed and left with the Administrator.