Routine inspection·November 27, 2023

On 11/27/2023 at around 9:10 AM, Licensing Program Analyst (LPA) Socorro Leandro conducted an unannounced Required – 1 Year Inspection to the above-named facility and met with the Administrator Cheresa Reyes. LPA explained the purpose of the visit and was accompanied by a caregiver inside and outside the facility during this inspection. This facility is licensed to serve 6 non-ambulatory adults ages 60 and above, of which 6 can be bedridden and/or in hospice care. A total of 6 residents are currently residing in this facility, of which 4 are ambulatory and 2 are non-ambulatory residents. The Annual Licensing Fees are current. The facility is a single-story structure located in a residential neighborhood. The home consists of the following: 6 resident bedrooms, 3 bathrooms, 1 living/dining/kitchen room area, 1 garage, 1 backyard patio area with shaded seating. Outside grounds were toured and no bodies of water were observed. The patio furniture is under a shaded area and accessible to residents. LPA observed an opened cable box with exposed wires on an exterior wall of the home. There are no security bars or weapons on the premises. LPA observed mildew on the garage walls. LPA toured the kitchen area and observed supplies of nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days. LPA observed unlocked cabinets with knives, cleaning solutions, and medicine. All medications observed were labeled and maintained in compliance with label instructions and State and Federal law. Documents are posted as mandated. Last Disaster drill was conducted on 8/16/2023. First aid kit is fully stocked with manual. Smoke and carbon monoxide detectors were in compliance and operational. The fire extinguisher was last serviced on 12/07/2022 and was observed near the kitchen area. 6 out of 6 resident’s bedrooms were checked. Mattresses were in good condition, adequate lighting, plenty of dresser and closet space observed. Walls and floors were clean and in good condition. Comforters, bed linen, bath towels and mattress protectors were adequately stocked. Bathroom toilets and water faucets worked properly, grab bars were secure, and a non-skid mat was in place. Adequate lighting and toiletries accessible to residents. LPA tested hot water temperature and it measured between 105 and 120 degrees Fahrenheit. This facility provides residents with hygiene products such as feminine napkins, nonmedicated soap, toilet paper, toothbrush, toothpaste, and comb. 5 staff records were reviewed, 5 out of 5 staff records had current First Aid Certificates, Criminal Record Clearances, Job Applications, Tuberculosis Test, Facility Trainings/Drills, and signed Employee Rights. 5 resident records were reviewed and, 5 out of 5 resident records had Admission Agreements, Medical Assessments, Consent Forms, Weight Record, Emergency Information, Appraisal & Needs Service Plan, Tuberculosis Test, Centrally Stored Medication Destruction Record, and Personal Rights. Deficiencies are being cited based on LPA observations in accordance with the California Code of Regulations, Title 22, see LIC809D. A violation regarding facility being in good repair and dangerous materials/solutions shall be inaccessible to residents with dementia. An exit interview was conducted, Plans of Corrections were reviewed and developed. A copy of this report and appeal rights were discussed and left with the Administrator.