Routine inspection·January 27, 2025

Licensing Program Analyst (LPA) Nancy Guillen made an unannounced visit for the purpose of conducting a required annual Inspection. LPA was greeted and granted entry by Administrator (AD) Noemi A Figueroa after explaining the purpose of the visit. LPA observed the Administrator Certificate is current and expires on December 19,2026. This is a Residential Care Facility for the Elderly (RCFE) licensed to six non-ambulatory residents, with a hospice waiver for four. The facility is a two-story home with three resident bedrooms, two staff bedrooms, two resident bathrooms, one staff bathroom, a living room, a dining room, an activity room, a kitchen and an attached garage. During the inspection, LPA and AD conducted a tour of the inside and outside of the facility, common areas, resident rooms, and observed the following: LPA observed residents watching television in the living room and resting in their respective bedrooms. LPA observed four residents in care and three staff present. LPA observed the See Something Say Something Poster (PUB 475) mounted on the wall in the living room. All resident bedrooms had the required furnishings. LPA observed all resident beds had linens and blankets with additional linens stored in the hallway closet. LPA observed bathrooms were clean and equipped with grab bars and non skid floor mats. LPA observed all windows were appropriately screened. Bathroom was observed to be free of debris and mildew, faucets and toilets were operational. Water temperature tested at 116.4 and 119.3 degrees Fahrenheit. LPA toured the outside of the facility and observed outdoor passageways were free of obstruction and hazards. LPA observed the backyard had a shaded sitting area with furniture for resident use. Continued on LIC 809 LPA observed the facility had 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. Two fire extinguishers were observed to be fully charged and located in the kitchen and activity room with a service date of September 20, 2024. Gas stove, microwave, washer, and dryer were all inspected and observed to be operable. The garage is used for storage and is kept locked and inaccessible to residents. Toxic chemicals, cleaning solutions, and disinfectants were observed to be locked and inaccessible to residents under the kitchen sink, garage and an outdoor storage. LPA observed knives were stored and locked in a kitchen drawer. LPA observed the First Aid Kit had all the required components. Upon record review, LPA observed Disaster Drills are not conducted quarterly; a deficiency was cited on today’s date. During medication review, medication was observed to be centrally stored in a safe locked hallway closet located next to the kitchen. LPA reviewed medication and observed medication was labeled and stored inaccessible to residents in care, however medication for two out of four residents did not have a doctor’s order; a deficiency was cited on today’s date. LPA reviewed four resident files. All the required documentation were present and current in the residents’ files reviewed. LPA reviewed three employee records. LPA observed records reviewed have a current First Aid certificate. All employee’s present have a criminal record clearance and were associated to the facility. One out of three staff were observed missing a health screening report and proof of a negative TB test; a deficiency was cited on today’s date. Based on the observations made during today’s inspection, 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 and appeal rights was left at the facility. This report was reviewed with the Administrator and a copy of this report was provided to the facility.