Routine inspection·September 13, 2024

Licensing Program Analyst (LPA) Christian Gutierrez conducted the annual inspection using the Compliance and Regulatory Enforcement (CARE) tools. LPA was met by Caregiver Priscilla Santos and explained the purpose of the visit. House manager Victoria Santos and Licensee Eduardo Medal arrived shortly. Facility is licensed to serve residents over 60 years old six (6) can be non-ambulatory, of which one (1) may be bedridden in room #4. Approved hospice waiver for six (6). During today’s visit it was observed facility had one (1) staff S5 member who has yet to be fingerprinted civil penalties assessed. The facility is a single-story building located in a residential area five (5) resident bedrooms, three (3) resident bathrooms, living room, kitchen, dining area, laundry/medication room, front yard backyard with gated pool, pool house and ADU. LPA obtained city permits for ADU however it was observed during tour of facility that ADU was occupied by someone not associated with facility with no fingerprint clearance civil penalties assessed. LPA toured the facility and observed the following: Each client bedroom has the required furniture and bedding. There is extra clean linen and towels in a hallway closet. Auditory devices were observed at entrances/exits and operating properly. Smoke detectors/carbon monoxide were observed in each room and throughout the facility and are properly operating. The facility has one (1) fully charged fire extinguisher which is kept in the kitchen. Cleaning supplies and toxic substances were observed to be inaccessible to clients in laundry room. 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 hot water temperature in the bathrooms were measured between the required range of 105-120 degrees F. LPA observed scissors in drawer unlocked in bathroom #1 and no grip bars in bathroom #1-2 deficiency cited. There is a pool surrounded with a locked safety fence. There is a shaded seating area for the residents located in the backyard. Passageways and exits are free of obstruction. Four (4) Staff files were reviewed and included Criminal clearance record, CPR/training, and health screening with TB. Four (4) Client files were reviewed and included physicians report, TB clearance. Fire/earthquake drill was last conducted August 4 th , 2024. Infectious control plan was reviewed. The medications are centrally stored and locked in laundry room. The facility uses the Medication Administration Record (MAR) log to document medications given. LPA reviewed medications for Four (4) clients, and they are being administered as prescribed by the physician. Deficiencies have been noted on LIC 809D under Title 22 Regulations. Exit interview was conducted and a copy of this report, LIC 809D and appeal rights were provided.