Routine inspection·February 20, 2024

Licensing Program Analyst (LPA) Tao conducted an unannounced annual inspection visit. LPA met with administrator Kenneth and consultant Vanessa whose assisted with visit. The facility is licensed to serve six (6) non-ambulatory residents, ages 60 and above, of which one (1) may be bedridden. Bedroom#6 is approved for bedridden. The facility has an approved Hospice Waiver (for six (6) residents) and a Dementia Care program. Administrator certificate is current and the expiration date is 11/24/24. Annual fees are current. During the visit, the CARE tool was used, staff /residents were interviewed, staff/residents records were reviewed, physical plant was conducted, food supply was reviewed, and medications were reviewed. The facility is a single-family residence located in a neighborhood, consisting of six (6) bedrooms, three (3) full bathrooms, 1 quarter bathroom (only has a toilet and a sink), kitchen, dining room, sun room, den, nook, laundry room, office, and living room with a TV. No pools and bodies of water on the premises. All the rooms were furnished with appropriate furniture for residents’ comfort. The bathrooms were furnished with grab bars and nonskid surfaces. Common areas were observed for the ability to safely serve the needs of the residents. Hot water temperature was 114.6 degrees Fahrenheit which was within Title 22 Regulation guidelines. Adequate linen and personal hygiene supplies was observed. Auditory alarm devices to monitor exits were operable. Sufficient supply of perishable and nonperishable foods is observed. Smoke and carbon monoxide detectors are dual/hardwired and operable. Fire extinguishers’ last service is 3/23/23 and are fully charged. Medication is centrally stored in a locked cabinet and inaccessible to residents. Resident records are stored in a locked cabinet and inaccessible to residents. Outdoor facility space used for residents and leisure are completely enclosed by a fence with self-closing gates. No deficiencies were observed and cited per California Code of Regulations, Title 22. An exit interview was conducted. This report was discussed and provided to Administrator.