Routine inspection·September 8, 2023

On 9/8/2023, Licensing Program Analyst (LPA) Alfonso Iniguez conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Mark Cumming /Administrator. LPA explained the purpose of today’s visit. The facility is licensed to serve (6) residents ages 60 and above of which (4) may be non-ambulatory and (2) Bedridden in room #2 and #4. Facility has an approved hospice waiver for (6) residents. The facility is a single-story structure located in a residential neighborhood. It consists of (6) resident bedrooms, (4) resident bathrooms, (1) staff bathroom, living room, entertainment room, dining room, and kitchen gated pool. LPA Iniguez toured the physical plant with administrator. There were no obstructions on the premises. A locked gate around the pool was observed and to access the pool, a locked door needs to be open. A total of (3) rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, and storage for the resident’s personal belongings was observed. Bathrooms were found to be within Title 22 regulations and were operational. LPA inspected rooms: #1, #2, and #3 and smoke and carbon monoxide combo are all operable conditions. The water temperature properly measured between 105°-120°F: Kitchen 105.6°F, Bathroom #1:106.9°F and Bathroom #2:107.8°F Evaluation Report Continues 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, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. All fire extinguishers were charged and were operable. A review of (3) residents' service files, (3) staff personnel files and (3) Medication Administration Records (MAR) were maintained in order. First AID kit was checked. Last facility disaster drill was on:8/16/2023. A copy of the liability insurance was provided to LPA during visit. LPA observed the facility's infection control practices. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe deficiencies therefore no citations were issued at this time. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Mark Cumming/Licensee.