Routine inspection·July 20, 2023

Licensing Program Analyst (LPA) Tao conducted an unannounced annual inspection visit. LPA met with Administrator, Silvia Castro.and explained the purpose of today's visit. Facility is licensed to serve six (6) non-ambulatory residents, age 60 and above, of which one (1) maybe bedridden. Annual licensing fee is current. Administrator certificate is current and the expiration date is 10/14/23. During the visit, CARE tool was used, a tour of the facility was conducted, food supply was reviewed, staff/resident files were reviewed, and medications were reviewed. The facility is a single story house located in a residential neighborhood. LPA toured the facilities physical plant, indoor and outdoor. The facility consisted of 4 residents bedroom, 2 1/2 bathrooms, dining room, kitchen, TV/living room, and family room. Residents’ rooms were well furnished and in compliance. Bathrooms inspected were clean, operable, with the required grab bars and non-skid materials in the shower. Hot water temperature was in a range of 106.1 degrees Fahrenheit which was within Title 22 Regulation guidelines. Adequate linen and personal hygiene supplies was observed. No pools and bodies of water on the premises. Auditory alarm devices to monitor exits were operable. Interior and exterior space available to permit residents to wander freely and safely. Sufficient supply of perishable and nonperishable foods was observed. A dual device of smoke detectors combined with carbon monoxide detectors were tested and operable. Fire extinguishers’ last service was 03/18/23 and fully charged. Medication were centrally stored in a locked storage room and inaccessible to residents. Resident records were stored in a locked storage room and inaccessible to residents. No deficiencies were observed during the visit. An exit interview was conducted. This report is discussed and provided to facility Administrator, whose signature on this form confirm receipt of these documents.