Routine inspection·October 27, 2023

On 10/27/2023, Licensing Program Analyst (LPA) Lourdes Montoya conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with House Manager Myrna Dennis and explained the purpose of the visit. At around 11:15 AM, Administrator Beulah Soleta arrived and joined the visit. The facility is licensed to operate for six (6) non-ambulatory elderly residents ages 60 and above. The facility is approved for two (2) hospice residents. The facility is a single-story structure located in a residential neighborhood. The facility consists of the following: six (6) resident's bedrooms, two (2) resident bathrooms, two (2) staff bedrooms, one (1) staff bathroom, a living room area, dining area, and kitchen. The washer and dryer are located next to one of the staff bedrooms. There is a shaded patio area with ample seating area for the residents. The facility does not handle residents’ cash resources. Facility Annual Fees are current during today’s visit. Administrator's certificate expires 4/1/2024. At around 11:00 AM, LPA toured the inside and outside grounds of the facility with House Manager Myrna Dennis. Carbon monoxide and smoke detectors were tested and found to be operable. The last facility fire drill was on August 8, 2023. LPA observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, and toxins were stored and not accessible to clients. The kitchen was inspected and there are sufficient two-day perishable and seven-day non-perishable food supplies. There are no pools or bodies of water on the premises. There are no firearms on the premises or other dangerous weapons. Centrally stored medications are locked in a cabinet located in the medication room. The first aid kit has all required supplies. The facility has a written emergency disaster plan posted in the living room. The facility is maintained at a comfortable temperature. There are working lights or lamps in each room at the time of visit. There are grab bars for each toilet and shower used by residents. Showers have non-skid floors. Report Continued in LIC 809-C LPA observed the following deficiencies: 1. One resident (R3) is bedridden according to Physician's Report. 2. The hot water temperature in the residents' common bathroom was 146.0 degrees Fahrenheit. 3. Three residents don't have current Appraisal/Needs and Services Plan. 4. Two staff don't have health screening records/TB test records. 5. Three residents don't have TB test records. 6. Fire extinguishers were last serviced on 9/14/202. Further inspection is needed. LPA will return to conduct additional inspection and to issue additional citations. Some of the above deficiencies are being cited based on LPA observations, interviews conducted and records review in accordance with the California Code of Regulations, Title 22, see LIC809D. Civil penalty is being assessed. An exit interview was conducted, Plans of Corrections were reviewed and developed. A copy of this report and appeal rights were discussed and left wit Administrator Beulah Soleta.