Routine inspection·September 21, 2023

On 9/21/2023, Licensing Program Analyst (LPA) Alfonso Iniguez conducted an unannounced annual required using the CARE Inspection Tool. LPA met with Algel Culala / House Manager. LPA explained the purpose of today’s visit. The facility is licensed to serve (6) residents ages 60 and above of which (4) non-ambulatory, (2) bedridden. Facility has an approved hospice waiver for (4) patients. Now facility has (6) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: five (5) residents' rooms, two (2) common bathrooms, a living area, a dining area, a kitchen, and an outside area. LPA Iniguez toured the physical plant with House Manager. 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 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 110.9°F, Bathroom #1:106.5°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, and sharps objects were stored and not accessible to residents. See D page for unlocked toxins and cleaning supplies. 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. LPA observed the facility's infection control practices. Deficiencies cited under California Code of Regulations, Title 22, Division 6, Chapter 8. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Algel Culala/House Manager.