Routine inspection·September 12, 2024

On 9/12/2024, Licensing Program Analyst (LPA) Alfonso Iniguez conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Josefina Guiao /House Manager. LPA explained the purpose of today’s visit. The facility is licensed to serve (4) elderly adults ages 60 and above, of which (4) can be non-ambulatory. The facility has an approved hospice waiver for (2). The clients are from Harbor Regional Center. (1) Restricted Health Care Conditions, and (1) utilizes postural support or protective devices. Staff to client ratio is (1:2). The facility is a single-story structure located in a residential neighborhood. It consists of four (4) bedrooms, two (2) full bathrooms, shaded back yard, front yard, laundry room, family room, living room/office, kitchen, empty pool covered, sun room and attached two (2) car garage. LPA Iniguez and the house manager toured the physical plant. There are bodies of water but covered no obstructions on the premises. LPA inspected a total of (4) bedrooms and (2) bathrooms. The beds and bedding supplies were in good condition, adequate lighting was provided, and storage for the residents’ personal belongings was observed. The bathrooms were found to be within Title 22 regulations and were operational. Smoke and carbon monoxide detectors were in operable condition. The water temperature ranged from 108.5°F to 115.2°F, and the room temperature ranged from 76°F to 78°F. The evaluation Report continues on the next page, LIC 809-C , providing further details of the inspection findings. During the visit, LPA Iniguez observed that the facility was clean, sanitary, and appropriately furnished. Storage areas for personal hygiene were in place. Cleaning supplies, toxins, and sharp objects were stored in a way that made them inaccessible to residents in care. The kitchen was inspected, and there was sufficient perishable and non-perishable food available, which was adequately maintained. All fire extinguishers were charged and operable. The last Fire/Disaster Drills were conducted on 8/24/24. A review of (3) residents' service files and (3) staff personnel files was conducted. LPA reviewed (3) Medication Administration Records (MARs) and found no discrepancies. LPA observed the facility's infection control practices. All mandated inspection control posters were displayed throughout the facility. A copy of liability insurance was emailed to LPA . Facility Annual Fees are not current, LPA Iniguez provided PIN #583489 to House Manager. Deficiency cited under California Code of Regulations, Title 22, Division 6, Chapter 8. See details below: -Staff separated from facility in Guardian on 5/31/24. -Expired CPR card for DSP. -No LIC 500 available at the time of annual visit. Note: *Citations not cleared by the due date will be a $100 fine assessed for each citation until it is cleared. Civil penalties will continue to accrue until Proof of Corrections (POC) is cleared. * An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Josefina Guiao /House Manager .