Routine inspection·February 28, 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 Caregiver Laura Perdomo. Administrator (AD) Manuel Perez arrived shortly after. For today’s visit, LPA observed a total of 3 residents in care and 1 staff member on duty. LPA observed the Administrator's Certificate for facility AD Manuel Perez which expires on 01/09/2025. LPA Ramirez toured the interior and exterior portions of the facility with AD Perez. The facility is a single level structure and is licensed for 6 non-ambulatory residents. For this visit, there are a total of 3 residents in care. There are a total of 4 bedrooms, of which 4 are private resident bedrooms. 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 2 restrooms. 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 106.7-108.1 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 in the hallway. CONTINUED ON LIC809-C... LPA Ramirez observed the emergency disaster and evacuation plan, which is posted by the dining room. Facility had back-up emergency food and water supply, located in the garage. 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 canopy with patio furniture, and the grounds were free of any hazards. There are 2 gates in the backyard, which both were self-closing and self-latching. In the backyard LPA observed a fenced and empty jacuzzi. 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 Perez. A copy of this report was provided at the time of exit.