Routine inspection·May 6, 2024

This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of conducting a Required – 1 Year Inspection. LPA met with Administrator (AD) Gheorghe Borduz and discussed the purpose of the inspection. LPA reviewed Infection Control requirements. At about 2:00PM, LPA and AD conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, and garage and observed the following: Structure: facility is a 6-bedroom, 4-bathroom, one-story house with detached garage that is being used for storage. There is a back yard with a patio cover for the residents. LPA and AD observed 2 staff and 1 resident present at the facility. Resident Bedrooms: the 3 resident bedrooms are spacious and will easily accommodate the residents’ furnishings. Furniture for each resident bedroom inspected. Staff Bedrooms: LPA inspected the 3 staff bedroom. Bathrooms: the bathrooms were clean, faucets and toilets were operational. Water temperature: tested at 110 degrees F and 111 in the 2 resident bathrooms. Linens & Hygiene Supplies: new linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu: reviewed. Food Service: LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food is available as required by regulations. Carbon Monoxide, Smoke Detectors, Fire Extinguisher: observed and tested. Appliances: stove burners, microwave, washer, and dryer inspected. Knives: observed locked in the medication cabinet. Toxins: observed locked in the garage. Medication cabinet: observed to be locked. First-Aid Kit and Activity Supplies: observed and available. Facility’s licensing fees are paid. At about 3:00PM, LPA reviewed 1 resident file and 3 staff files, interviewed 1 resident and 1 staff, and inspected medications for 1 resident. Facility does not handle resident money. CONTINUED During the inspection, LPA and AD observed the following: based on documents and admission, the licensee did not ensure the facility currently has liability insurance; based on documents, the licensee did not maintain training records for S1 and S2; based on documents, the licensee did not document medication training for S1 and S2; based on documents and admission, the facility has not been conducting emergency disaster drills; and based on observation, the fire extinguisher was purchased in 2021 and has not been certified in the last year. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.