Routine inspection·August 28, 2024

On 08/28/2024 at around 10:00 AM, Licensing Program Analyst (LPA) Socorro Leandro conducted an unannounced Required – 1 Year Inspection to the above-named facility and met with Licensee/Administrator Robert Smith. LPA explained the purpose of the visit and was accompanied by Licensee inside and outside the facility during this inspection. This facility is licensed to serve 6 non-ambulatory adults ages 60 and above, of which 1 may bedridden. This facility is approved for 4 hospice residents. A total of 3 residents are currently residing in this facility. The Annual Licensing Fees are current. The facility is a one-story house located in a residential street. The home consists of 3 resident bedrooms, 2 bathrooms, 1 living room, 1 dining/office room, 1 kitchen, 1 attached garage (has been converted to 2 rooms and is under construction), and 1 backyard patio area. Outside grounds were toured and no bodies of water were observed. The patio furniture is under a shaded area and accessible to residents. LPA observed clutter (items that were in the garage such as, bikes and several household items) in the backyard, walkways around the home, and the facility’s back door leading to the trail is in disrepair. There are no security bars or weapons on the premises. LPA toured the kitchen area and observed supplies of nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days. Knives and toxins were kept in locked storage cabinet. LPA observed that medications were safe, locked, and inaccessible. All medications observed were labeled and maintained in compliance with label instructions and State and Federal law. Documents are posted as mandated. First aid kit is fully stocked. Smoke and carbon monoxide detectors were in compliance and operational. The fire extinguisher is in the kitchen area and was last serviced on 12/08/2023. There is a videoconferencing device (laptop) and a land line telephone dedicated for client use in the office area. LPA observed clutter (miscellaneous household items on counter-tops, office table, and floor) in the living room, dining/kitchen area. 1 staff record was reviewed, 1 out of 1 staff record had required documentation. 3 resident records were reviewed and, 3 out of 3 resident records had required documentation. Technical Assistance is being issued regarding California Code of Regulation (CCR), Title 22, Alteration to Existing Building, 87305(a). Licensee will connect with his Licensing Program Analyst, Mario Leon. 1) Licensee will have their local authority (city) inspect their new construction and receive approval for their new construction. 2) Licensee will email approval of their new construction and an updated facility sketch (LIC 999) to Mario.Leon@dss.ca.gov . A deficiency is being cited based on LPA observation in accordance with the CCR, Title 22. A violation regarding CCR, Title 22, Maintenance and Operation, 87303(a). An exit interview was conducted, a copy of this report was left with the Licensee along with their appeal rights.