Routine inspection·October 14, 2024

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required annual inspection. LPA was greeted and granted entry by staff. LPA met with Administrator Hermelinda Perez and explained the reason for the visit. LPA observed the See Something Say Something Poster (PUB 475) posted in the entry way of the facility. The Administrator, Hermelinda Perez's Administrator's certificate expires on October 30, 2024. LPA and Administrator toured the facility. The facility is a 2 story house with 5 bedrooms, living room, kitchen, dining room, 3 bathrooms and a 2 car garage. The facility is licensed for 6 non-ambulatory residents, hospice waiver for 2, no bedridden allowed. LPA observed both bathrooms are clean and operational. The hot water measured 109.4 degrees Fahrenheit. LPA observed all resident rooms had the required furnishings and bed linens. The smoke detectors/carbon monoxide detectors tested operational. LPA observed the kitchen is clean and organized. LPA observed a 2 day perishable and a 7 day non-perishable food supply on hand in the kitchen. The 4 burner gas stove lights unassisted. LPA observed the knives and sharp objects are kept locked in a kitchen drawer. LPA observed the garage is kept locked and used for storage of supplies, extra food and emergency food and water. LPA observed the medication is kept locked in a cabinet in the garage. LPA toured the backyard. LPA observed there is a plastic shed in the backyard. The shed is used for storing extra furniture and kept locked. The exit gates leads to the front courtyard. No bodies of water observed. There is shaded seating in the backyard. No obstacles or hazards observed in the backyard. LPA toured the second floor of the facility. No residents live upstairs. There are 2 bedrooms upstairs and 1 bathroom. LPA reviewed 2 staff files, no discrepancies observed. LPA reviewed 6 resident files and medications, no discrepancies observed. There is no facility record of an emergency disaster drill taking place in the last 3 months. Deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of the report provided.