Routine inspection·June 14, 2024

Licensing Program Analysts (LPA) Erik Zaragoza conducted an unannounced Required 1-year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA explained the purpose of the visit to Gerardo Navallo, caregiver for the home, and was granted entrance to the facility. Administrator Iwona Kaya arrived shortly thereafter. There are five (5) residents currently living in the facility, of which one (1) of them is on hospice. The following 12 (CARE) tool domains were observed and reviewed: Infection Control, Physical Plant/Environment Safety, Operational Requirements, Staffing, Personnel Records/Staff Training, Resident Rights/Information, Resident Records/Incident Reports, Food Service, Planned Activities, Incident Medical and Dental, Disaster Preparedness, and Residents with Special Health Needs. Infection Control: · Infection control plan was present within the facility. Physical Plant/Environment Safety: · The facility is a single-story home located in a residential neighborhood. It is licensed for a capacity of six (6) non-ambulatory residents, along with a hospice waiver approved for six (6) residents. The facility consists of a kitchen, a living room, a dining room, four (4) resident rooms, a staff room, an office, three (3) resident bathrooms of all three (3) had a hot temperature reading between 97.7 Degrees F, 97.1 Degrees F, all of which fell below the required range of 105 – 120 degrees Fahrenheit, a backyard patio area, and an attached garage that contains the facility’s washer and dryer machines and emergency food supplies. The facility’s chemicals, cleaning supplies, and knives are kept locked and inaccessible to residents. The facility was observed to be in good repair. · The interior and exterior physical plant was inspected. Exit doors are free of any obstruction. The facility has two (2) fully charged fire extinguisher located in the kitchen of the facility as well as in the garage. · Water temperature readings fell below the required range of 105 - 120 degrees Fahrenheit. Operational Requirements: · The Program Design was reviewed. · Fire clearance was approved by LA County Fire Department for a capacity of six (6) non-ambulatory residents, along with an approved hospice waiver for six (6) residents · Care and supervision to meet the clients’ needs was observed. Staffing: · Six (6) full-time staff members provide care and supervision to the clients. Personnel Records/Staff Training: · Five (5) staff files were reviewed for criminal background clearance and training. · Four (4) out of five (5) staff records reviewed have health/TB screenings, however one (1) did not have a completed health screening on file. All had current 1st Aid/CPR training. · The administrator’s certificate expires on 8/15/2025. Resident Rights/Information: · Physician orders were reviewed for five (5) resident files. · Medications were also reviewed for five (5) residents. Resident Records/Incident Reports: · Five (5) resident files were reviewed containing admission agreements, Physician's Report, medical/functional assessments, Needs and Services Plans, TB clearance, Appraisal/Needs and Services Plan, personal rights, medical consent, and medication records were reviewed. Food Service: · The kitchen was inspected and has sufficient supply of 2-day perishable & 7-day non-perishable food. Kitchen, food preparation area, and storage areas were observed to be clean and sanitary. Incident Medical and Dental: · All residents have an Appraisal/Needs and Services Plan on file. · Staff training was on file. Disaster Preparedness: · Emergency and Disaster Plan was publicly posted and found within the facility. · The last emergency and disaster drill was conducted on 6/11/2024. Planned Activities: · Sufficient Space is provided to accommodate both indoor and outdoor activities. · Sufficient equipment and supplies are provided to meet the requirements of the activity program. Residents with Special Health Care Needs: · A hospice care plan was in place for the one (1) resident who is on hospice. · There is an adequate number of staff to support each resident’s physical, social, emotional, safety and health care needs as identified in his/her appraisal. Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiencies observed during the visit is documented on the LIC809D. Exit interview held and a copy of the report along with appeal rights were provided.