Routine inspection·November 7, 2025

At approximately 10:00 AM, Licensing Program Analysts (LPA) Julie Florio arrived unannounced to conduct a required 1-year annual inspection and was greeted by Justin Herold, Administrator. Facility is a Residential Care Facility for the Elderly (RCFE) with seven (7) residents in care. Facility has a Dementia Care Plan, a Hospice waiver for four (4), with three (3) Hospice residents currently in care, and is approved for all non-ambulatory residents. At approximately 11:00 AM, LPA initiated a tour of the facility with Administrator and observed the following: Facility is a one story home, was a comfortable temperature, and passageways were free from obstructions. Water temperatures in residents' bathrooms measured within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed a supply of clean linens, and hygiene, incontinent care, and paper products available for residents. Residents' bedrooms were inspected and observed to have all the appropriate furnishings as outlined in Title 22 regulations. Cabinets containing cleaning supplies and other items that could pose a risk were locked. Facility has at least two days of perishable food and LPA informed Administrator of the requirement to maintain one week of non-perishable foods. Administrator agrees to bring the facility into compliance immediately, as well as obtain an emergency supply of water. Medications were centrally stored and locked. There is a shaded seating area in the backyard with outdoor space for activities. LPA observed two locked sheds in the backyard. LPA inspected and observed the contents of one consisting of furniture, resident care equipment, tools, and holiday decorations. LPA inspected and observed the contents of the second one containing a water tank which is not currently being used. LPA observed backyard gates all secured with bolt lock. Continued on LIC809-C... Continued from LIC809... Administrator states the fire department will be at facility next week and Administrator will consult with them about which ones need to be changed to latch locks in order to operate in compliance with fire code. LPA observed a piano, book shelves full of books, puzzles, and crafting supplies in the living room off of the main entrance. LPA observed residents enjoying live music during today's inspection. LPA was informed that the facility plans to develop more routine activities. Facility has internet access and Administrator agrees to ensure an internet access device is designated for resident use. Facility telephone was tested an operational during inspection. Facility has five (5) fire extinguishers which were observed charged and were last serviced 01/2025. Smoke and Carbon Monoxide detectors were tested and operational during inspection. Facility recently changed administrators and disaster drill logs were not available. Administrator states that facility will conduct an Lastly, emergency disaster drill next week and understands that drills shall be conducted no less than quarterly to remain in compliance with regulation. LPA observed the facility's infection control plan, first aid kit, PPE, flashlights, and emergency supplies. Administrator states facility has a generator for emergency preparedness. LPA reviewed facility's emergency disaster plan last updated 1/2024. At approximately 1:00 PM, LPA conducted file review. Four (4) staff and four (4) residents' files were reviewed and LPA observed the following: Three (3) of four (4) staff files reviewed were missing proof of both initial and annual training to include medication training. Administrator states that with change of leadership documents are incomplete or lacking from files. LPA provided Administrator with Health and Safety Code sections which detail the training requirements and Administrator agrees to being the facility into compliance immediately. Additionally, two (2) of four (4) staff files were missing proof of current CPR and First Aid training certification. Administrator agrees to ensure all staff receive proof of certification immediately. Lastly, two (2) of four (4) staff files reviewed were missing the required health screenings with proof of negative TB results. Administrator agrees to being the facility into compliance immediately. Four (4) of four (4) resident files reviewed were observed missing current needs and services plans which Administrator agrees to complete and review with the residents' responsible parties immediately. Continued on LIC809C... continued from LIC809C... Lastly, two (2) of two (2) resident files reviewed were observed missing the required consent forms, which Administrator agrees to obtain and ensure all are present in resident files moving forward. LPA discussed the requirement that all staff and resident records are current and present in the files. Administrator agreed to ensure the facility is operating within compliance at all times moving forward. . At approximately 3:00 PM, LPA reviewed medications and medication records which are maintained and stored in compliance with regulation. Administrator states that the residents families coordinate residents' medical and dental appointments and transportation to and from visits. However, Administrator also states that facility will assist with coordinating these appointments and transportation for residents upon request. Facility does not manage P&I. LPA discussed the Department's Technical Support Program (TSP) with Administrator who has agreed to utilize this service. LPA will submit a referral for Administrator. Administrator had to leave at 3:15 and gave permission for a designated responsible party (DRP), staff Norma Rodriguez to sign today's visit report. Updated copies of the following documents are to be submitted to CCL within 30 days of this visit : -LIC610E - Emergency Disaster Plan (updated) -LIC500 Personnel Report (updated) No deficiencies were cited during today's inspection. Exit interview conducted with DRP whose signature on form confirms receipt.