Routine inspection·July 24, 2024

Licensing Program Analyst (LPA) Rosaura Valenzuela conducted an unannounced annual visit. LPA met with Caregiver Estellita San Pedro and explained the reason for the visit. The facility is licensed to serve 5 non-ambulatory residents ages between 60 and over and a hospice waiver for 2 hospice residents. Facility is a one story single home in a residential area and consists of the following: 3 bedrooms, 3 resident bathrooms, 1 staff bathroom, garage, gated pool with pool house. Backyard has an area with tables/ umbrellas for shade. Facility has a living room, kitchen/dining room and front porch. Pool house is inaccessible to residents. LPA Valenzuela conducted a tour of the facility with Caregiver Estellita San Pedro and observed the following: Living room has a cover fireplace, sufficient sitting area, and signs posted. Medication cabinet is located in the living room and was observed to be locked. Knives and cleaning supplies were observed to be locked under the kitchen sink. Facility has sufficient food supplies for at least 2 days worth of perishables and 7 days of non-perishables. Residents rooms were observed as follows: Room #3 (R3) has all required furniture and bedding, Room #1(R1) and Room #2(R2) have all required furniture, bedding, and sufficient lighting. Water temperature was measured at 120 degrees F, which is not within the required 105-120 degrees F. Smoke/Carbon Monoxide detectors were observed, tested, and in working condition. Fired extinguisher was observed in the kitchen. Files were reviewed for 4 residents. Five staff files were also reviewed. There is one complete first aid kit. Continue on 9099-C No health or safety issues observed at the time of this visit. Exit interview conducted and a copy of the report was issued.