Routine inspection·November 9, 2024

Licensing Program Analyst (LPA) Christian Gutierrez conducted the annual inspection using the Compliance and Regulatory Enforcement (CARE) tools. LPA met lead Caregiver Gino Puzalan at approximately 11:10 AM and explained reason for visit. Licensee Osvaldo Santa Ana arrived shortly. This home is licensed to serve age range 60 and over. Approved for 6 non-ambulatory of which one (1) may be bedridden. Approved hospice waiver for two (2). This home contains 3 resident bedrooms, 1 staff bedroom, 2 bathrooms, living room, kitchen, dining room and an attached garage. LPA toured the facility and observed the following: Each resident’s bedroom has the required furniture and bedding. There is extra clean linen and towels in a hallway closet. Smoke detectors were observed in each room and throughout the facility and are properly operating. There is 1 carbon monoxide in the hallway and is properly operating. The facility has one (1) fully charged fire extinguishers which is kept in the kitchen. Cleaning supplies and toxic substances were observed to be inaccessible to residents locked under kitchen sink. Freezers are maintained at a temperature of 0-degree F and the refrigerators at a maximum of 40 degrees F. Sufficient supply of 2 days perishable & 7 days non-perishable foods was observed in the kitchen. Sharps are locked and placed in cabinet in kitchen. There are no firearms or weapons stored at the facility. The two bathrooms contain a working toilet, basin, and water faucet, walk in shower with grab bar, shower chair, and bathmat. The hot water temperature in the bathrooms were measured between the required range of 105-120 degrees F. The facility does not have a swimming pool or bodies of water on the premises There is a shaded seating area for the residents located in the backyard. Passageways and exits are free of obstruction. The garage is clean and has extra supplies and freezer. SEE LIC 809C Four (4) Staff file reviewed and included Criminal clearance record, CPR/training, and health screening. Six (6) residents files were reviewed and included physicians report, TB clearance and apparel needs and service plans. Fire/earthquake drill was conducted in October of 2024.Infectious control plan was reviewed. The medications are centrally stored and locked in a cabinet in kitchen The facility uses the Medication Administration Record (MAR) log to document medications given. LPA reviewed medications for residents, and they are being administered as prescribed by the physician. No deficiencies were observed or cited during today's inspection exit interview conducted with Caregiver Gino Puzalan.