Routine inspection·December 28, 2023

On 12/28/2023, Licensing Program Analyst (LPA) Alfonso Iniguez conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Nelson Ortega/Caregiver and later Virgina Asis/Designee Administrator. LPA explained the purpose of today’s visit. The facility is licensed to serve (6) non-ambulatory elderly adults ages 60 and above and approved hospice waiver for (6). (2) May be bedridden. Bedroom #3 is cleared for (1) bedridden client. The home consists of two (2) floor levels: the first floor consists of (3) resident bedrooms all of which are shared rooms, (2) restrooms, kitchen, dining room, living room, and attached 2 car garage. The second floor consists of 3 bedrooms occupied by staff. LPA Iniguez toured the physical plant with administrator. There were no bodies of water or obstructions on the premises. A total of (3) rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, and storage for the residents’ personal belongings was observed. Bathrooms were found to be within Title 22 regulations and were operational. LPA inspected rooms: #1, #2, and #3. smoke and carbon monoxide combo are all operable conditions. The water temperature ranged from 102.5F° – 118.2F°. The room temperature ranged from 76F° – 78F°. Evaluation Report continues on 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. Working landline phones are available on-site. LPA reviewed (3) residents' service files (R#1-R#3) and (3) staff personnel files (S#1-S#3). Medication Administration Records (MAR) were maintained in order. First AID lit was checked. Last fire disaster drill was on: None. Licensee will email copy of liability insurance to LPA. LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. Deficiencies cited under California Code of Regulations, Title 22, Division 6, Chapter 8. Exit interview conducted with Ortega Nelson /Caregiver and a copy of the appeal rights were given at the time of the visit.