Routine inspection·August 13, 2024

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required annual inspection. LPA met with Administrator Olga Moreno and Cristo Forero and explained the reason for the visit. The facility is a two story home with 5 bedrooms, 3 bathrooms, living room, dining room, kitchen and a 2 car garage. Facility has a capacity for 4 non-ambulatory residents and a hospice waiver for 1. The second floor is for live in staff. The second floor has 3 bedrooms and 2 bathrooms. Residents only reside on the first floor. LPA observed the See Something, Say Something poster posted in the hallway measures 8 1/2 by 11 inches. LPA observed the Ombudsman poster posted next to the stairway. The Administrator's Certificate expires on December 18, 2024. LPA Observed the fireplace in the living room is screened. The smoke detectors tested operational. The carbon monoxide detector in the living room tested operational. The facility does not have internet service at this time. LPA observed the bathroom downstairs for residents is clean and operational. Hot water measured 116.2 degrees Fahrenheit. LPA observed the kitchen is clean and organized. Knives are kept locked in the kitchen cabinet. LPA observed medications are kept locked in the kitchen cabinet. LPA observed a 2 day perishable and 7 day non-perishable food supply on hand in the kitchen. The 4 burner gas stove lights unassisted. LPA reviewed 2 staff files. No discrepancies observed. LPA reviewed 3 resident files. LPA observed Resident 3 (R3) did not have a current appraisal/needs and service plan. No other discrepancies observed. LPA reviewed 3 resident medications, no discrepancies observed. LPA and Administrator toured the backyard. No bodies of water observed. There is a shade patio area to sit outside. The exit gate is operational. LPA inspected the garage. The garage is kept locked and used for storage. LPA inspected the first aid kit. The first aid kit has all the required elements. LPA consulted with the Administrator concerning reporting requirements. Deficiencies are being cited per Title 22 Division 6 of the California Code of Regulation. An exit interview was conducted and a copy of the report provided.