Routine inspection·September 6, 2024

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of conducting the Required Annual Inspection. LPA was greeted and granted entry by facility caregiving staff after introducing himself and stating the reason of the visit. Administrator Rita Lee was notified of the visit via telephone and could not assist with the visit in person. During the inspection, LPA and facility staff conducted a tour of the physical plant and observed the following: The facility is a one-story home with five private bedrooms and one locked staff room. There are two shared bathrooms which are observed to be equipped with grab bars and slip mats. All resident bedrooms have the required furnishings. LPA observed all beds have linen and blankets. Postural supports are present with orders on file. There are currently five residents admitted to the facility, one of which is receiving hospice care. Bathrooms faucets and toilets are operational. Water temperature was verified to be within acceptable range. LPA observed emergency disaster plan with means of exiting and emergency phone numbers listed present on the premises. Fire drills are conducted quarterly. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food. Smoke and carbon monoxide detectors tested operational. Fire extinguishers present are observed to be fully charged. There is adequately shaded outside space with outdoor furniture present. There are self-latching gates on both sides of the house and routes of egress are free of obstructions. Medication, cleaning products and sharp items are confirmed to be inaccessible throughout the physical plant. The medication central storage was also observed to be secure and reviewed for accuracy. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 LPA reviewed five resident files and three staff files. Resident records include all necessary components. All staff members are confirmed to be cleared and associated with this particular licensed location with up-to-date first aid/CPR training. LPA additionally conducted three resident and two staff interviews. Based on the observations made during today’s inspection, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. Two Technical Assistance advisory note are provided with a consultation on the required Infection Control Plan as well as updates to the residents' medical assessments. An exit interview was conducted with the administrator over the phone, and a copy of this report was provided to a facility representative.