Routine inspection·November 22, 2024

Licensing Program Analysts (LPAs) Nancy Guillen and Rose Ruppert made an unannounced visit to the facility today to conduct an Annual Required Evaluation. LPAs were greeted and granted entry by Staff #1 at 1:45 PM. During today’s visit, LPAs met with Menandro Tanuyan, Administrator Designee. The facility is a single story, five bedroom, three bathroom residential home with an approved fire clearance of six non-ambulatory residents of which four may be on hospice. The facility currently has a census of six residents in care, of which four are on hospice. During today’s visit, LPA Guillen toured the facility and inspected the physical plant, including but not limited to testing all smoke detectors and testing hot water temperatures in two of two resident bathrooms . A third bathroom is primarily for staff. The hot water temperatures measure d between 119.4 and 120 degrees Fahrenheit and all smoke detectors were operational . The fire extinguisher is charged and was serviced on October 29th,2024. The facility’s last fire drill was conducted in 2023. LPAs observed the PUB 475 poster was not the 20" X 26" required size and advised staff to post the theft and loss and visiting hours in a prominent place near the entryway. LPAs inspected the facility food supply and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand. LPA Guillen observed spices were past expiration dates and immediately removed them. LPA Guillen advised staff to continue to look through pantry for any additional expired items and to throw them out. LPA Ruppert observed medication storage and reviewed the centrally stored medications. Per review medications are being given as prescribed. (Continued on LIC 809-C) (Continued from LIC 809) LPAs reviewed three of three staff training and fingerprint records and conducted a complete review of resident records. LPAs interviewed alert residents regarding their quality of care and spoke to staff present regarding care provided. LPAs confirmed that administrator has an active administrator certificate which will expire on August 29th, 2026 . The following deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with Menandro Tanuyan, Administrator Designee and a copy of this report was given to the facility along with a copy of the LIC 858, LIC 859; LIC 9102-TV, LIC 809-D and Appeal Rights.