Routine inspection·May 24, 2024

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to the facility today to conduct an Annual Required Evaluation. LPA was greeted and granted entry by Kenneth Forsyth, Administrator (AD). During today’s visit, LPA met with AD and Louie Dormido, Licensee (LE). The Residential Care Facility for the Elderly (RCFE) is a single story building with an approved fire clearance of six non-ambulatory residents, a hospice waiver for two residents of which zero may be bedridden . There is a fenced swimming pool with locked gates into pool area. All backyard exit gates are unlocked with latches. The facility currently has a census of six residents in care. During today’s visit, LPA toured the facility and inspected the physical plant, including but not limited to testing all smoke detectors, testing hot water temperature in two of two resident bathrooms, and testing auditory devices on all exits . The hot water temperature measured between 110.6 and 124.3 degrees Fahrenheit and all smoke detectors were operational . There is no record of the facility’s last fire drill. LPA inspected the facility food supply and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand . LPA observed medication storage and reviewed the centrally stored medications. Per review completed medications appear to be being given as prescribed. LPA conducted a complete review of resident and staff records. LPA interviewed alert residents regarding their quality of care and spoke to staff present regarding care provided. LPA confirmed that administrator has a current administrator certificate which expires on February 15, 2025. AD is associated with Lois Guest Home II next door. LE faxed the transfer request immediately to regional office. The following deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with Louie Dormido, LE and Kenneth Forsyth, AD and a copy of this report was given to the facility along with a copy of the LIC 858; 859;809-D and Appeal Rights.