Routine inspection·March 6, 2025

Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to conduct the required annual inspection. LPA was greeted and granted entry by care giving staff after explaining the purpose for the visit. Administrator (AD) Rizalina Reyes was notified via telephone and later arrived to assist with the inspection. LPA observed that Administrator Rizalina Reyes has a valid Administrator certificate which expires on June 30, 2025. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents with a hospice waiver for three. The facility is a single-story home with four resident bedrooms, two of which are shared, one staff bedroom, two shared resident bathrooms, a living room, a dining room, a kitchen, and an attached two car garage. LPA accompanied by the AD conducted a tour of the interior portion of the facility. On today's visit, LPA observed three residents in care, none of which are on hospice, and three care giving staff present. LPA observed residents relaxing in the living room as well as their respective bedrooms. LPA observed the See Something, Say Something poster (PUB 475) mounted on a wall in the resident hallway. LPA inspected the four resident bedrooms, and they were observed to be free of any hazards. LPA observed the resident bedrooms had the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPA observed each resident has an internet device in their bedroom. All resident beds had clean linens and blankets. LPA observed additional linens are stored in a hallway closet. LPA inspected the two shared resident bathrooms. Resident bathrooms are clean. Bathrooms are equipped with grab bars and non-skid floor mats. Faucets and toilets were operational. Hot water temperature measured between 65.6 and 132.2 degrees Fahrenheit. LPA observed the staff room is kept locked and inaccessible to residents in care. LPA observed the kitchen has a two day perishable and seven day nonperishable food supply on hand. LPA observed kitchen appliances to be clean and operational. The four top electric stove was operational. LPA observed knives and sharps are stored in a locked storage cabinet in the kitchen. CONTINUED ON LIC809-C A fire extinguisher is located in the kitchen and it was observed to be charged and serviced on September 4, 2024. LPA tested the individual smoke detectors and carbon monoxide detectors which tested operational. LPA observed the facility conducted their last emergency disaster drill on October 1, 2024. The centrally stored medication is kept in a locked cabinet in the resident hallway. A First Aid kit was observed be stored in the locked cabinet and it was observed to be missing scissors, a thermometer, and a tweezer. The door leading to the attached two car garage is kept locked and inaccessible to resident. The garage is used for storage and laundry. LPA observed chemicals and toxins to be stored in the locked garage. LPA observed the facility has a three day emergency food and water supply stored in the garage. LPA and the AD conducted a tour of the exterior portion of the facility. LPA observed the exterior portion to be clear of obstructions and hazards. LPA observed a shaded outdoor seating area with furniture for resident use. The perimeter gates on the north side and southside of the facility are self-latching and can be opened in an evacuation. There are no bodies of water on the premises. LPA reviewed all three resident files. LPA observed the facility did not have a Pre-appraisal on file for Resident #3 (R3). LPA observed the facility did not have a Reappraisal on file for Resident #1 (R1), Resident #2 (R2), and Resident #3 (R3). LPA reviewed all three residents’ medication and medication records. LPA reviewed four staff files. LPA observed that 0 out of the 4 care giving staff had a valid CPR training card on file. LPA observed that 0 out of the 4 care giving staff did not conduct the required annual training for the year of 2024. All staff are background cleared and associated to the facility. Based on today's observations, deficiencies are being cited per Title 22 of the California Code of Regulations. An exit interview was conducted with Administrator Rizalina Reyes. A copy of the report and Appeal Rights were provided.