Routine inspection·December 1, 2022

Licensing Program Analyst (LPA) Mora conducted an unannounced annual visit at the facility with focus on the infection control domain, medication and food review. LPA Mora met Euphrosyne Dimaano - Administrator and explained the reason for the visit. The facility is licensed to serve 6 non-ambulatory residents ages 60 and over, of which 1 may be bedridden, and may retain up to 6 hospice residents. The facility is operating within the scope of its license. The facility is located in a residential area. A tour of the single-story facility included: 4 resident bedrooms, 2 bathrooms, living room, kitchen, dining area, attached garage, front yard, and backyard. LPA and Euphrosyne Dimaano toured the facility and the following was observed: sufficient supply of 2 days perishable & 7 days non-perishable foods was observed in the kitchen. Auditory devices were seen on all exit doors which are required for dementia residents and were operating at the time of the visit. The water temperature was tested in both bathrooms and measured at 116.6 and 118.9 degrees F which is within the required 105 - 120 degrees F. The bathrooms are clean and have the required grab bars in the shower and near the toilet for non-ambulatory residents. The shower has non-skid materials. Resident bedrooms have the required furniture such as bed frames, dressers, lamps and chairs. Resident beds have the required linen and the linen is in good condition. There is extra clean linen and towels in the hallway cabinets. Smoke detectors were observed in each room and throughout the facility and are properly operating. A carbon monoxide was observed in the hallway and it is properly operating. A fire extinguisher was observed in the kitchen which is fully charged. Kitchen appliances are clean and were operating at the time of the visit. Knives are kept locked under the kitchen sink. Cleaning chemicals are kept locked under the bathrooms' sinks. First Aid kit was fully stocked with current manual. The front and backyard are well maintained. There is a shaded seating area for the residents located in the backyard. There are no bodies of water. Passageways and exits are free of obstruction. Medication was (CONTINUED TO LIC 809C) Residents medication are centrally stored in a locked living room closet. Residents and staff files are centrally stored in the garage. LPA reviewed medication for all 4 of the residents and observed that medications are given as prescribed. LPA reviewed files for 4 residents and 4 staff and observed no deficiencies. LPA observed administrator certificate for Euphrosyne Dimaano - 6031893740 with an expiration date of 02/12/2024. Facility has 30 days supplies of Personal Protective Equipment in the garage. Facility is following COVID-19 recommendations regarding screening visitors, staff, and clients. Covid-19 prevention signs are posted throughout the facility and hand-washing signs were observed in the bathrooms. Sufficient hand soap, hand sanitizer, and paper towels were observed. Per California Code of Regulations, Title 22, and California Health and Safety Code, there was no deficiencies observed during the visit. Exit interview held and a copy of the report was provided.