Routine inspection·April 18, 2025

Licensing Program Analysts (LPAs), Mayra Cota and Blanca Gonzalez, conducted an unannounced required annual visit. LPAs met with Marianela Campos, Caregiver and explained the reason for the visit and she assisted LPAs with the tour of the facility. Km Dhammike Keerthisnghe, Administrator, arrived shortly after. The facility is licensed to serve six (6) non-ambulatory of which two (2) may be bed-ridden. Waiver granted for Hospice Care for six (6). The facility is operating within the scope of its license. Facility is in a residential area of Downey. During the visit, LPAs toured the facility's indoor and outdoor environment, reviewed three (3) resident and (3) staff files, and conducted medication review. The facility is a single-story house which consists of a receiving area, office area, living room/dining area, kitchen/laundry closet, two (2) private resident bedrooms, two (2) shared resident bedrooms, one (1) staff bedroom, three (3) bathrooms, front and backyard and detached garage. During today’s visit, LPAs observed the following: Inside the home: Living room and dining area were observed clean and furniture is in good repair. Resident bedrooms have the required furniture such as dressers, lamps, and chairs. Bedrooms also have sufficient closet space. Resident beds have the required linen and mattress pads. Bed rails have the required physician orders in place. Rooms housing oxygen tanks have the required signs posted on the doors. Resident oxygen tanks have the proper stands and extra tanks are stored properly. ***Continue on LIC 809-C Sharps/knives, cleaning supplies and toxins were observed locked under kitchen sink and are inaccessible to residents. Sufficient supply of 2 day perishable and 7 day non-perishable food was observed. Food in the refrigerator and the cabinets was observed labeled and kept within expiration limits. Menus and Dietary Guidelines are posted in the kitchen. Kitchen appliances are clean and were operating at the time of visit. Three (3) full bathrooms were inspected and were observed clean. Showers have handrails and anti-slip mats. The water temperature was tested in all three (3) bathrooms and measured within the required 105 - 120 degrees F. Laundry closet was inspected and laundry appliances (washer and dryer) were observed to be working properly. Detergents are kept locked and inaccessible to clients. Sufficient personal hygiene products observed in storage cabinets throughout the facility. Outdoor environment: The front and backyard are well maintained and there are no pools or large bodies of water. Backyard has a patio area with outdoor furniture and shade. Patio furniture is in good repair and there is enough seating for clients in care. Garage is kept clean and free of clutter. Passageways and exits are free of obstruction. Disaster Preparedness and Emergency Intervention: Facility is equipped with back up generator which is located in the garage and a solar panel with a back up battery located in the backyard. Drills are conduced quarterly. Last fire/safety drill was conducted on 2/1/25. First Aid kit was reviewed and contained required tools and manual. Facility has one (1) fire extinguisher which was observed charged and operable. Emergency Disaster plan and Infection Control Plan reviewed and observed to be up to date. Facility is equipped with a fire sprinkler system and smoke and carbon monoxide detectors observed throughout the facility, were tested and working properly. ***Continues on LIC 809-C Medication Review: Medication is centrally stored and locked in medication cabinet. Client medication was reviewed and observed to be dispensed per physician's orders and documented accordingly on MAR. Per California Code of Regulations, Title 22, and California Health and Safety Code, no deficiencies are cited today. Exit interview conducted with Km Dhammike Keerthisinghe, Administrator, and a copy of the report was provided.