Routine inspection·January 31, 2025

Licensing Program Analyst (LPA) Nune Margaryan conducted an Annual Required visit and inspection of the facility. LPA met with the Administrator Rosemarie Honrado and Licensee Adelaida Asuncion. LPA explained the purpose of the visit. During the visit, the CARE tool was used. The facility is licensed to serve Dementia residents, ages 60 and above, approved for two (2) non-ambulatory and four (4) ambulatory residents. Currently, there is no hospice resident in placement. The facility is a single-story house located in a residential neighborhood. It consists of five (5) bedrooms including three (3) resident bedrooms, one (1) staff room, one (1) room for family member; three (3) bathrooms, kitchen, dining room, living room, and detached garage. Facility was toured, staff/residents files were reviewed. Residents medications were reviewed. No pools and bodies of water on the premises. All residents' bedrooms and bathrooms were inspected. The front and backyard are well maintained and there are no pools or large bodies of water. There is a shaded seating area for the residents located in the backyard. The common areas are clean and have the required furniture. The resident bathrooms have the required grabs bars and non-skid mat. The water temperature was tested and was measured within Title 22 Regulation guidelines. Resident bedrooms have the required furniture such as bed frames, dressers, lamps, and chairs. Bedrooms also have sufficient closet space. The kitchen was inspected. LPA observed that kitchen equipments are in working condition but the stove and refrigerator were dirty with oil stains all over. Kitchen cabinets also needed cleaning. LPA observed sufficient supply of perishable and non-perishable foods. There is additional food in the refrigerators located in the garage. Adequate linen and personal hygiene supplies was observed. Auditory alarm devices to monitor exits were operable. Last fire drill was conducted on 12/07/24. Knives and sharps are locked in the kitchen and inaccessible to residents. Smoke detectors and carbon monoxide detectors are operable. Fire extinguisher observed in the dining room and fully charged. Continue 809C Laundry area was observed in the covered patio between the house and garage. Laundry detergents were observed locked next to the washer and dryer and in the garage. The outdoor activity area has a shaded patio with ample seating. Medication is centrally stored in a locked cabinet; resident and staff records are stored in a locked room and both inaccessible to residents. First Aid kit was fully stocked with current manual. LPA reviewed 3 resident records to confirm emergency contact is updated, physician's reports are on file, and admission agreements are complete. Two staff records were reviewed to confirm health screenings, training, and fingerprint clearances. LPA reviewed 3 residents' medications. Medications are documented properly and given as prescribed. Per California Code of Regulations, Title 22, the deficiency observed are documented on the attached 809D. Exit interview held. A copy of the report and appeal rights were provided to Adelaida Asuncion.