Routine inspection·December 17, 2024

Licensing Program Analyst (LPA) Christian Gutierrez conducted an unannounced annual inspection using the Compliance and Regulatory Enforcement (CARE) tools. LPA was met by Caregiver Alan Punsalan at approximately 9:00 AM and explained reason for visit. House manager Maria Quiogue arrived shortly. Facility is licensed to serve six (6) residents over 60 years old four (4) can be non-ambulatory. Hospice waiver approved for Three (3). The facility is in a residential area, and it is a one-story family home. A tour of the single-story facility included the living room, kitchen, dining room, three (3) client bedrooms, one (1) staff room, 2 bathrooms, front yard, backyard, attached garage. LPA toured the facility and observed the following: Each resident’s bedroom has the required furniture and bedding. R1 did not have physician orders for bed rail deficiency cited. There is extra clean linen and towels in garage cabinet. Smoke / carbon monoxide detectors were observed in each room and throughout the facility and are properly operating. The facility has two (2) fully charged fire extinguishers which is kept in kitchen and hallway. Cleaning supplies and toxic substances are inaccessible locked in cupboards in kitchen. 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. 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. Bathrooms had required grab bars and nonskid mats. 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. Garage has an extra freezer and supplies. SEE LIC 809C Three (3) Staff files were reviewed. Administrator did not have file at facility deficiency cited. Two (2) resident files were reviewed and were missing physicians report, consent forms, personal rights LIC 613, and appraisal needs and service. Fire/earthquake drill was not conducted deficiency cited. Infectious control plan was not available. The medications are centrally stored and locked in a cabinet in dining room. LPA reviewed medications for all residents, 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 to Maria Quiogue.