Routine inspection·December 15, 2022

On 12/15/2022, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility in order to conduct a required annual inspection. LPA was greeted and granted entry by Manny Balana, caregiver after explaining the purpose of the visit. Administrator Mel Amante was notified of the visit by telephone and arrived shortly afterwards to assist with the visit. LPA accompanied by caregiver toured the physical plant of the facility. There are currently four (4) residents in care. Residents present are observed relaxing in their respective bedrooms or in the common areas with visitors and appear clean and well taken care of. Bedrooms are all equipped with the required elements of furnishing. Resident R-1's bed is observed to be equipped with half rails for postural support. Resident is confirmed to be receiving hospice care. The two bathrooms are equipped with grab bars and slip mats. An ample supply of linen is observed. Facility is observed to be clean, sanitary and free of odors in all areas inspected. Sharp instruments are kept secured in a kitchen drawer equipped with a functioning lock. Cleaning supplies are stored under the kitchen sink. The magnetic lock for one of the two doors is observed to be non-functional during the visit. The centrally stored medication is located in a cabinet with a functional magnetic lock that is observed to be functional. LPA observed a sufficient supply of food and water present. The fire extinguisher present is charged and mounted. The maintenance tag is however outdated with the last maintenance performed in October of 2019. The fire extinguisher was replaced during the inspection. Staff members present are adequately cleared and associated in Guardian. Administrator certificate on display is shown to be current. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 LPA and caregiver toured the outside of the facility. Outdoor furniture and a shaded area are present in the backyard for the enjoyment of residents and visitors. The perimeter gates on both sides of the house are shown to be equipped with padlocks, one of which is observed to be locked during the visit. Administrator states that the facility occasionally locked these due to residents wandering. More recently, a concern regarding break-ins in the neighborhood has prompted facility staff to lock the gates at night. LPA provided consultation on the applicable regulations for the locking of gates. Padlocks were removed during the duration of the visit. There are no bodies of water on the premises. The laundry area is located in the attached garage, where staff lockers are also located. Laundry detergents are stored in a locked cabinet equipped with a padlock. However, a box containing spray paint as well as a plastic bag containing laundry detergent and fabric softener for use by staff members are observed to be left out. The staff bedroom door is observed to be left unlocked by staff present. Medications are observed in the room and are accessible to individuals in care. Based on the observations made during today’s visit, two deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. A Technical Violation advisory as well as two Technical Advisory notes are also being issued during the visit. This report was reviewed with facility representative and a copy of this report along with appeal rights was provided and left at facility.