Routine inspection·July 23, 2024

Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced visit today for the facility’s annual inspection. LPA met with Direct Support Staff, Janet Lapitan, Continual Administrator's Certification for Maria Sunglao is pending on the DSS website. There are currently 4 residents who reside at this home and there is 0 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. There is a locked storage for medications. Food supply is adequate for 2-day perishable and 7-day nonperishable. Fire extinguisher is within the safety regulation period. Smoke alarms were tested and are operational. The home has a carbon monoxide detector and performs disaster drills as required. First Aid kit is on site and complete. Toxins and cleaning supplies are locked and inaccessible. LPA Hurt observed facility window screen to be broken in disrepair. LPA Hurt observed the hallway resident bathroom faucet water to measure at 101 degrees. Resident 1 did not date his signed Admission Agreement, and also does not have the LIC 621 Safeguard for Personal Values form. Staff 1 checks blood sugar of Resident 2 with a lancet blood sugar monitor device. Staff 2 does not have a Health Screening Report. Water temperature was tested at 101 degrees. The following deficiencies observed or cited during today's inspection per California Code of Regulations, Title 22. LPA 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 Direct Support Staff, Janet Lapitan, and copy of report left at facility