Routine inspection·July 27, 2023

Licensing Program Analyst (LPA) Glenn Trueman made an unannounced visit and was greeted by Administrator Luzviminda Bulosan and explained the reason for the visit. The purpose of the visit is to complete the required inspection. LPA Trueman toured the facility along with Administrator Luzviminda Bulosan today 07/27/2023 at 1:00 PM and the following was observed Facility contains 4 Resident Bedrooms and 2 client bathrooms dining room, kitchen, and TV room. Hot water temperature measured between 105 F. and 120 F. meeting Title 22 Regulations. Required Annual Inspection included Infection Control Practices, Operational Requirements, Physical Plant/ Environmental Safety, Staffing, Personnel Records/ Staff Training, Resident Records/ Incident Reports, Resident Rights/ Information, Food Service, Planned Activities, Health Related Services, Incidental Medical and Dental, Disaster Preparedness and Resident's with Special Health Needs. LPA observed sufficient supply of 2 day perishables and 7 day non perishables. All staff were cleared and associated. Visitation signage was posted along with signage for hand washing and proper sanitizing. Licensee maintained an individual admission agreement for each client. Fire Clearance has been maintained. Each client has personal rights free from corporal or unusual punishment, infliction of pain, humiliation, ridicule, coercion, threats, mental abuse, or other actions of a punitive nature. Program site was clean, safe, sanitary, and in good repair at all times for the safety and well being of clients, employees and visitors. Medication was reviewed and was given per physician's directions. 3 Resident Files and 5 Staff Files were reviewed. Interviews were conducted with 2 Staff and 4 Residents. In Bedroom 3 resident had full bed rails and was not on Hospice. Physician's Report for Dementia resident was last done 06/14/2022 over 1 year ago. Deficiencies cited on 809 D. Exit interview conducted and copy provided.