Routine inspection·June 17, 2025

At approximately 10:45 AM, Licensing Program Analyst (LPA) Julie Florio arrived unannounced to conduct a required 1-year annual inspection and was greeted by Susanna Villasenor, Licensee. Carisma Patterson, Administrator was contacted via telephone and arrived at approximately 11:00 AM. Facility is a Residential Care Facility for the Elderly (RCFE) with three (3) residents in care. All residents were present during today's inspection. Facility has a hospice waiver for six (6), bedridden waiver for one (1), and is approved for all non-ambulatory residents. At approximately 11:30 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. LPA observed the required postings in the facility's entryway. 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 observed locked. Facility has at least two days of perishable food and one week of non-perishable foods, as well as an emergency water supply. Medications were centrally stored and locked. There is a shaded seating area in the backyard with outdoor space for gardening and activities. LPA inspected two locked sheds in the backyard which contained holiday decor, care equipment, PPE, tools, chemicals, and a back up generator for emergency preparedness. LPA observed residents watching TV or working on puzzles in the common area of the facility. Continued on LIC809C... Continued from LIC809... Facility has an internet access device designated for resident use. Facility has internet service available to residents in care and the telephone was tested an operational during inspection. Smoke and carbon monoxide detectors were tested and operational during inspection. Facility's two fire extinguishers were observed fully charged and were last inspected 05/2025. Facility conducts quarterly disaster drills with the last one conducted 03/2025. Facility has an emergency disaster plan which was last updated 04/2021. LPA reviewed three (3) resident records and three (3) staff records and observed the following: three (3) of three (3) resident records reviewed contained required documents. Administrator agreed to ensure that all of the required documents are complete and in the resident files in order to bring the facility into compliance with regulation. Three (3) of three (3) staff files reviewed have the required documents. However, three (3) of three (3) staff files reviewed were missing proof of the required initial and annual medication training, (see LIC809D). LPA reviewed medications and medication logs which were inspected and observed stored in compliance with regulation. Administrator agrees to ensure facility that centrally stored medication logs are maintained in compliance with regulation. Facility does not manage P&I. Updated copies of the following documents are to be submitted to CCL within 30 days of this visit : LIC500 Personnel Report (updated) LIC610 Emergency Disaster Plan (updated) Control of Property – Deed Copy of Administrator’s Certificate (updated) Proof of Liability Insurance (updated) Observed deficiencies (see LIC809D) were cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Administrator whose signature on form confirms receipt of documents. Appeal rights provided.