Routine inspection·February 28, 2024

On 2/28/2024, Licensing Program Analysts (LPA) Darneisha Cross and Alfonso Iniguez conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Gloria Somintac / House Manager. LPA explained the purpose of today’s visit. The facility is licensed to serve (6) residents ages 60 and above. Of which (6) may be non-ambulatory and (1) Bedridden. Approved hospice waiver for (6). The facility is a single-story structure located in a residential neighborhood. It consists of (5) bedrooms, (2) full bathrooms, shaded back yard, front yard, laundry room in the attached garage. LPAs toured the physical plant with staff. There were no bodies of water or obstructions on the premises. A total of (5) 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 the carbon monoxide detectors combo were in operable conditions. The water temperature measured: Kitchen 114.6°F, Bathroom #1:109.6°F. Evaluation Report Continues LIC 809-C LPA Iniguez observed the facility to be clean, sanitary, and appropriately furnished at the time of the visit. Storage areas for personal hygiene, cleaning agent found unlocked underneath kitchen sink, 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 were checked. (3) Medication Administration Records (MAR) were reviewed no discrepancies were found. First AID kit was checked. Last fire disaster drill was on:2/8/2024. LPA observed the facility's infection control practices. Liability insurance will be emailed to LPA. Facility Annual Fees Current. Deficiency cited under California Code of Regulations, Title 22, Division 6, Chapter 8. See details below: -Missing SPV form for R#1, R#2 and R#3 -Missing medical assessment for R#1 and R#3 -Missing TB test for R#2 and R#3. -Missing Personal rights for R#3. -Trash can with no cover. -Unlocked ckeaning agent underneath kitchen sink An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Gloria Somintac /House Manager.