Routine inspection·April 19, 2024

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced visit for the Required 1 Year Inspection. LPA explained the purpose of today’s visit, and was greeted and granted entry by Administrator (AD) Fatima Rivera. For today’s visit, LPA observed a total of 4 residents in care and 2 staff members on duty. LPA observed the Administrator's Certificate for facility AD Fatima Rivera which expires on 10/06/2024. LPA Ramirez toured the interior and exterior portions of the facility with AD Rivera. The facility is a single level structure and is licensed for 6 non-ambulatory residents, of which 4 may be on hospice and 0 bedridden. For this visit, there are a total of 4 residents in care. There are a total of 6 bedrooms, of which 4 are private resident bedrooms, and 2 private bedroom for staff. LPA Ramirez toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. There are a total of 4 restrooms of which 2 are for staff and 2 are for residents. Restrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature tested between 109.5-110.8 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to residents in care. Fire extinguisher was charged, mounted and located by the laundry room. LPA Ramirez observed the emergency disaster and evacuation plan, which is posted by the kitchen hallway. Facility had back-up emergency food and water supply, located in the garage CONTINUED ON LIC809-C... LPA observed that First Aid Kit had all the required components. LPA observed that medications and toxins were locked and inaccessible to residents in care. For the exterior portion, LPA Ramirez observed a shaded area with furniture, and the grounds were free of any hazards. There is 1 gate in the backyard, which is self-closing and self-latching. No bodies of water were observed. LPA reviewed four resident files and two staff files. LPA interviewed residents and staff present. For today's visit deficiencies were issued per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with AD Rivera. A copy of this report was provided at the time of exit.