Routine inspection·May 24, 2022

Licensing Program Analyst (LPA)Andrea Mendivil conducted an unannounced visit for the purpose of conducting a required annual visit. LPA was greeted and granted entry into the facility by Caregiver Irene Shields and explained the reason for the visit. At 9:35 AM Administrator Evelyn Wallace arrived during the visit. At 9:10 AM, LPA toured the facility. Facility is 5 bedroom, 3 bathroom single story home with a detached garage. Facility has 5 residents present during today's visit. LPA observed residents relaxing in the facility and in their respective rooms. LPA Mendivil observed postural supports on 5 out of 7 beds. All residents rooms had the required elements as well as restrooms stocked with soap. LPA observed the screening/ sanitizing station in the entrance of the facility. Facility takes residents temperatures daily and documents. The facility mitigation plan has been completed and approved. LPA observed emergency food and did not observe emergency water. LPA observed unsecured prescription medication in kitchen cabinet for new resident. LPA observed locked medication cabinet.LPA observed unlocked knives in a drawer in kitchen and unsecured cleaning supplies under sink and above washer and dryer. LPA toured the outside grounds and observed outside shaded visitation area. Exit gate is unlocked and self latching. Exit gate is blocked by trash cans and discarded furniture. Facility has a plan for covid testing residents and staff as needed as well as a plan for isolation .LPA observed one pack of masks for facility. LPA reviewed all residents files and all contained required documentation including updated emergency information. All staff and residents are vaccinated for Covid 19. Based on the observations made during today’s visit, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with the facility representative and a copy was provided as well as appeal rights.