Routine inspection·May 22, 2024

On today's date, Licensing Program Analysts (LPAs) Michael Tea and Sean Haddad conducted an unannounced Annual Required-1 year inspection visit. LPAs were granted entry by Administrator (AD) Ramona Miclea. AD Certificate for Ramona Miclea expires on 9/18/2025. This is a facility licensed for a capacity of six non-ambulatory residents which two can be on hospice. At 1:30 PM, LPA Tea and Haddad reviewed whether the following is in compliance: licensee is operating the facility within the conditions and limitations, which are specified on the license, including the capacity limitation, after corrections. The facility is a 1 story home. The home consists of: 3 private staff rooms, 4 resident bedrooms, which 2 are shared, 2 restrooms for residents and 1 bathroom for staff , 2 living rooms, kitchen with dining area, 2 car garage used for storage and supplies and a back yard. Between 1:50 PM - 2:20 PM, LPAs reviewed 2 of 2 staff records, 6 of 6 resident records. Residents files and staff files contained all required documentation. At 2:20 PM, LPA Haddad reviewed 6 of 6 client centrally stored medication records. LPAs observed medications are secured in a secured cabinet in staff room, not accessible to clients in care, after corrections. 6 of 6 Medication records were found to be within Title 22 CCR, after corrections. At 2:56 PM, LPAs along with AD Miclea conducted the tour inspection. A tour of the interior and exterior of the facility and physical plant were inspected, including but not limited to testing hot water temperature in resident and common bathrooms. The resident bathroom water tested and measured about 113.0 degrees Fahrenheit. All smoke detectors, carbon monoxide, were operational and functional. LPAs verified if facility is providing a comfortable temperature due to hot/cold weather condition. Facility has a working centralized heater and air conditioner to use for the cold or hot weather as needed. The temperature inside the facility was recorded to be 76 degrees Fahrenheit. CONTINUED ON LIC 809-C PAGE... CONTINUED... LPAs reviewed facility telephone; provision of sufficient lighting; exit obstructions, if any; and potential hazards. Poisons, toxic substances, and other dangerous objects were noted to be secured in staff area and inside garage not accessible to clients in care, after corrections. Kitchen knives were stored and secured, not accessible to clients in care, after corrections. The Outside grounds were inspected during facility tour. LPAs observed sitting area with a shaded patio. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises. AD reported offering the following indoor and outdoor activities at the facility for residents such as doing puzzles, crafting bead jewelry, playing card games, and taking walks around the neighborhood, walking as far to the community pool in the neighborhood. Two fire extinguishers observed and fully charged, and last tested on December 19, 2023. AD reports fire drills are conducted with staff and clients. Last facility fire drill was conducted on March 4, 2024. Plentiful basic hygiene items and linen supply were available. First Aid KIT and other aide supplies were observed to be stored in secured cabinet in. Furnishing cleanliness and state of repair, and fixtures were examined. Nonskid mats were observed in resident restrooms. Operational and functional Washer and Dryer were observed in garage area. The following deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with Ramona Miclea and a copy of this report was given to the administrator.