Routine inspection·August 30, 2024

Licensing Program Analyst (LPA) Tao conducted an unannounced annual inspection visit. LPA met with Administrator, Paula Mera, who assisted with the visit. The facility is licensed to serve residents ages 60 and above, with a capacity of six (6) residents including six (6) non-ambulatory of which one (1) may be bedridden. The facility had dementia care program. Annual fees were current. Hospice waivers were approved for two (2) residents. Currently, there are three (3) hospice residents residing at the facility. For today’s inspection visit, the CARE tool was used; a physical plant was conducted; food supply was reviewed; staff/residents were interviewed; and staff/residents’ facility records along with medications were reviewed. Administrator certificate is current with expiration date on 11/22/24. The facility was located in a residential neighborhood. The facility consisted of five (5) resident bedrooms, one (1) which is a shared room, two (2) bathrooms, a kitchen, dining room, office area, living room, shaded patio, and attached garage. The facility had secured perimeters with a motorized gate in the front to prevent residents from leaving the property. All the rooms were furnished with appropriate furniture for residents’ comfort. (-continued in LIC 809C-) The bathrooms were furnished with grab bars and nonskid surfaces. Common areas were observed for the ability to safely serve the needs of the residents. Hot water temperature was 119.8 degrees Fahrenheit. Adequate linen and personal hygiene supplies were observed. No pools and bodies of water on the premises. Facility maintained a comfortable temperature for residents. Interior and exterior space available to permit residents to wander freely and safely. Sufficient supplies of perishable and nonperishable foods were observed. Knives, tools, sharp items were inaccessible to residents. Smoke detectors and carbon monoxide detectors were operable. Fire extinguishers were fully charged. Medication, residents’/ staff’s records were centrally stored in a locked cabinet and inaccessible to residents. Toxic substances were inaccessible to residents. Deficiencies were observed and cited per California Code of Regulations, Title 22, in LIC 809 D. An exit interview was conducted. This report and Appeal rights were discussed and provided to administrator Paula.