Routine inspection·April 10, 2023

On 4/11/2023, Licensing Program Analyst (LPA) Felisa Shirley conducted an unannounced One-Year Required Visit at the facility. LPA met with the Licensee Edith Nagel and conducted a risk assessment. Facility is approved to serve 5 non-ambulatory residents and 1 bedridden resident over the age of 60. LPA reviewed client records, staff records, medications, and inspected the entire facility. LPA and Edith inspected the entire facility inside and out. The facility has 5 resident bedrooms, 3 bathroom and 1 staff bathroom, a living room, a fireplace in the living which is cover by a metal fireplace screen. a dining room, and a kitchen. The outdoor facility has a backyard with a pool inaccessible with a 5-foot fence around it. All client rooms were checked. Mattresses and box springs were in good condition, adequate lighting, plenty of dresser and closet space was observed. Walls and floors were clean and in good repair. Bed linens, comforters and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulation. Toilets and water faucets worked properly. Shower was free of mold/mildew, adequate lighting, and sufficient toiletries accessible to clients. Water temperature measured 112.7 degrees. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Carbon monoxide detector was operational. Smoke detectors were working properly, fire extinguishers were fully charged and operational, toxins and knifes were locked and inaccessible to clients. Medications were centrally stored and properly locked, first aid kit was checked and in order. Exits/Walkways around the home were free of debris and hazards. Continued on LIC 809C During today’s visit LPA observed that the facility has a half bed rail for R1 and R3 with no prescriptions in the file. LPA Shirley noticed during record review that Staff Iann Barrantes, Anita Lebon and Guadalupe Castillo were listed on the LIC500 Staff Roster but have no background clearance. Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. During today’s visit there were deficiencies observed, Title 22 Chapter 6 Regulations are being cited. Please see LIC809- D. Exit interview held. A copy of the report and appeals rights was provided.