Routine inspection·May 17, 2023

Licensing Program Analysts (LPA) Sarah Hurt, and Les Xiong conducted an unannounced visit today for the facility’s annual inspection. LPA met with Facility staff Vicenta Martinez Continual Administrator's Certification for Jessica Johnson expires 06/06/2023. There are currently residents 4 who reside at this home and there is 2 residents on hospice at this time. LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, activity rooms, medication storage, kitchen, garage and outdoor areas. Bedrooms were clean and in good repair. There is a locked storage for medications. Food supply is adequate for 2-day perishable and 7-day nonperishable. Smoke alarms were tested and are operational. The home has a carbon monoxide detector and performs disaster drills as required. Water temperature was tested at 114 degrees. First Aid kit is on site and complete. Toxins and cleaning supplies are locked and inaccessible. LPA's Hurt and Xiong reviewed Resident 1's Physician Report. Resident 1 is bedridden, and the facility does not have fire clearance for bedridden residents. LPA's observed knobs on kitchen stove with functioning knobs accessible to residents. LPA's observed the south backyard gate to be locked. LPA's observed Resident 2's Centrally Stored Medication log did not have current prescription information. LPA's observed the facilities door alerts leading to outside not functioning. The following deficiencies observed or cited during today's inspection per California Code of Regulations, Title 22. LPA's requested the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing. Exit interview conducted with facility staff, Vicenta Martinez and copy of report left at facility