Routine inspection·June 3, 2025

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced visit to Harbor View Estate. The purpose of today’s visit was to conduct the Annual Required inspection. LPA was allowed entry into the facility and explained the reason for the visit. Facility is licensed for 6 non-ambulatory residents and there are 5 residents present during today's visit. Facility has an approved hospice waiver for 6 residents and the home currently has 2 residents on hospice. Administrator Vilma Manuel has an administrator certificate valid until 03/07/2026. Upon entry, facility appears clean and sanitary. LPA Lyman along with Administrator Manuel toured the facility at 8:00 AM. LPA toured the physical plant, checked food service, first aid kit and reviewed records. The home consists of four resident bedrooms, 1 common restroom, 1 staff restroom, living room, dining room, staff room, office, laundry room and kitchen. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident rooms are single and double occupancy. At 8:10 AM, LPA observed facility has put up a divider in staff room. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured at 108.6 degrees F in facility restroom. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards. First aid kit had all the elements including thermometer, tweezers and scissors. LPA observed toxins are secured during today's visit. Auditory exit alarms are operational during today's visit. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Kitchen appliances are operational during today's visit. Smoke detectors and carbon monoxide detectors tested operational during today's visit. Fire extinguisher is fully charged. LPA toured the outside grounds and there is ample shaded seating for residents. Exit gates are unlocked and operational. At 8:25 AM, LPA observed recycling debris and wood pieces in side yard. CONT ON LIC809-C DATED 06/03/2025 LPA observed ample emergency food and water supply. LPA reviewed the emergency disaster plan and infection control and plans are thorough and complete. Facility provides activities in the form of exercise, and music therapy. LPA reviewed five resident files and three staff files. Resident files contained required documents including admission agreements, physician reports, physician orders for bed rails as indicated and resident appraisals. Staff files reviewed contained required documentation of medical clearance/ TB, CPR training and criminal record clearance as well as required training. LPA reviewed medication storage and administration. Medications are stored in a locked closet. Medications are being administered per physician order and facility audits medications weekly. Based on the observations made during today's visit, the following violation is being cited per California Code of Regulations, Title 22, Division 6, Chapter 8. An exit interview was conducted and a copy of this report as well as appeal rights were discussed and provided with facility representative.