Routine inspection·April 10, 2025

At approximately 9:45 AM, Licensing Program Analyst (LPA) Julie Florio arrived unannounced to conduct a required 1-year annual inspection and was greeted by Corina Anguiano, Designated Responsible Party (DRP). Administrator, Madonna Grace Martinez was contacted via telephone and was unable to leave the other facility they were working at today. LPA was given permission to proceed with today's inspection with DRP. Facility is currently on a quarterly non-compliance plan with the most recent non-compliance visit conducted on 04/01/2025. Facility is a Residential Care Facility for the Elderly (RCFE) with six (6) residents in care. All residents were present during today's inspection. Facility has a hospice waiver for three (3) and is approved for all non-ambulatory residents. At approximately 10:30 AM, LPA initiated a tour of the facility with DRP 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 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 activities. LPA inspected structure in backyard which a background cleared and associated tenant resides in. LPA also inspected two attached exterior closets which were observed to contain personal and household items. Continued on LIC809C... Continued from LIC809... LPA observed residents watching TV or reading in the common area and in their bedrooms. 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 02/2024. DRP spoke with Administrator who states they plan to take both to be serviced on of before 4/15/2024. Administrator agrees to submit proof of service to the Department. Additionally, LPA observed personal rights, a current administrator certificate, and the facility's emergency disaster plan not posted in a conspicuous area of the facility. LPA informed DRP these items shall be posted in order to bring the facility back into compliance with regulation. No deficiencies were cited during inspection. Updated copies of the following documents are to be submitted to CCL within 30 days of this visit : LIC500 Personnel Report (updated) Any other item previously requested during the noncompliance quarterly visit on 04/01/2025. Exit interview conducted with DRP whose signature on form confirms receipt of documents.