Routine inspection·October 16, 2024

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of conducting the required annual inspection. LPA was greeted and granted entry by facility caregiving staff after introducing himself and stating the purpose of the visit. House manager Sarah Levante was notified of the visit via telephone and arrived later to assist with the visit. LPA accompanied by staff conducted a tour of the physical plant and observed the following: the facility is a one-story home with an attached garage. The facility has four bedrooms, one of which is designated for use by an ambulatory resident. The fire clearance allows for three bedridden residents however none of the residents are bedridden at the time of the visit. There are two bathrooms on the premises, both observed to be equipped with grab bars and slip mats. All resident bedrooms have the required furnishings. Bathrooms faucets and toilets are operational. Water temperature was measured at 117.5F. LPA observed all beds have linen and blankets. There are half rails used for postural supports in two of the private bedrooms. Physician orders for both residents reviewed. There are currently three residents admitted to the facility upon placement from the Regional Center of Orange County. None of the residents are receiving hospice care. LPA observed emergency disaster plan with means of exiting and emergency phone numbers listed and posted. The facility is however still using the outdated LIC610E form in spite of the Advisory Note provided on that topic during the previous annual inspection conducted on October 30, 2023. Type B citation issued. Drills are conducted quarterly and documented. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Smoke and carbon monoxide detectors tested operational. Fire extinguisher present is fully charged and has been maintained in 2023. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 There is adequately shaded outside space with outdoor furniture present. There are self-latching gates on each side of the property. The routes of egress are free of obstructions. Medication, cleaning products and sharp items are confirmed to be inaccessible throughout the physical plant. The medication central storage was also observed to be secure and reviewed to be accurate and up to date with the resident's prescription orders. LPA reviewed three resident files along with ten staff files. Resident records include all necessary components. All staff members on the facility's roster are confirmed to be cleared and associated with this particular licensed location. Training and CPR training verified to be up to date, with proof of orientation training and in-services observed to be on file. Five staff members are observed to have completed the DSP Year One or Year Two training. Health screenings are on file for all staff members. Infection control plan reviewed. Personal rights poster PUB475 is observed to be posted on an 8x10 sheet in spite of the Advisory Note provided during the previous annual inspection. Type B citation issued. Based on the observations made during today’s inspection, two type B 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 along with appeal rights was provided to a facility representative.