Routine inspection·February 24, 2025

On February 24th, 2025 Licensing Program Analyst (LPA) William Vanegas made an unannounced inspection for the purposes of an annual inspection. Upon arrival LPA Vanegas was greeted and granted entry to the facility by Administrator (AD) Cynthia Barton. LPA Vanegas made the following observations This is a one storied home with three bedrooms one of which is a staff room and two of which are resident rooms and one of which is a staff room along with two bathrooms both accessible to residents in care. LPA Vanegas observed kitchen area to be clean and free of debris. LPA Vanegas observed a two day supply of perishable food and a 7 day supply of non perishable food. LPA Vanegas observed resident bathrooms to be clean and clear of debris. Resident bathrooms were observed to have all the required furnishings such as grab bars, shower chair, and slip resistant flooring. Water faucets and toilets tested to be operational and water tested between 113.6-116.3 degrees. LPA Vanegas observed resident rooms to be clean and have no obstructions blocking the doorways. Bedrooms were observed to have all required furnishings such as a lamp, chair, chest drawers, and a bed with clean linens in good repair meaning no strains or tears. LPA Vanegas did not observe a PUB475 (see something say something) Sign of the proper dimensions posted on the entrance of the facility a technical violation was given on today's date. LPA Vanegas did not observe an emergency disaster plan available for review nor did LPA Vanegas observe and infection control plan available for review. A deficiency was cited on today's date. Smoke and carbon monoxide detectors were tested and observed to be operational. LPA Vanegas observed a fire extinguisher to not be up to date and was expired. CONTINUED ON LIC809C LPA Vanegas reviewed resident #1's resident file and observed that not all required documentation was in the file. LPA Vanegas observed that there was no file available for review of resident #2. A deficiency was cited on today's date. LPA Vanegas was not provided with a staff file for staff member that was on duty at the time of the visit, however staff member is cleared to work at the facility. A deficiency was cited on today's date. LPA Vanegas reviewed all medications with AD, and per LPA Vanegas review all medications are being documented when administered, and are being administered per physicians orders. After observations made during today's visit deficiency's will be cited per tittle 22 chapter six of the California Code Of Regulations. An exit interview was conducted and a copy of this report was left at the facility.