Routine inspection·April 8, 2025

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry by facility caregiving staff after introducing himself and stating the purpose of the visit. Administrator Lorna Constantino was notified of the visit via telephone and informed LPA she would not be able to assist with the visit due to a family emergency. Administrator gave permission to her staff to assist with the annual visit and to sign the report on her behalf. There are currently six residents in care, two of which are receiving hospice care. LPA observed residents relaxing in their respective bedrooms or in the facility's common living areas. LPA accompanied by facility staff toured the physical plant. The facility is a one-story house with an attached garage. The facility has six private rooms There are two en-suite bathrooms and one shared bathroom throughout the facility. Bedrooms appeared clean and sanitary, however one bedroom is not equipped with a bed as facility staff indicates that resident requested a recliner seat instead upon admission. Facility staff however did not submit an exception request at the time of the visit. Type B deficiency cited. There are two beds equipped with half rails and one bed with full rails installed for postural support. Full rail orders are present in the relevant resident's hospice plan of care, however the other two half rails are not documented by physician orders available during the present visit. Type B defiency cited. Bathrooms appear clean and sanitary. Hot water temperature measured at 105F and 106F in two separate bathrooms with faucets used for personal grooming. Advisory provided. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 LPA observed the kitchen has a minimum two (2) day perishable and seven (7) day non-perishable food supply. Sharp items, cleaning products and the laundry area are secured. Fire extinguisher is charged and mounted. LPA tested the smoke and carbon monoxide detectors which were found to be operational. LPA and facility staff toured the outside of the facility. LPA observed multiple shaded outdoor seating areas with furniture for resident use. There is a self-latching gate on the exit route, which is not obstructed. There are no bodies of water on the premises. Facility does not utilize locked perimeters or delayed egress. LPA reviewed six resident records which were observed to be complete. One missing document for a recently admitted resident will be provided by the licensee at the earliest convenience. LPA reviewed resident medication records and prescription orders for all residents with no discrepancies observed. Oxygen is currently in use and adequate signs are present. There are no bedridden residents present on the premises. LPA reviewed staff records for both caregivers present. Records were found to be complete. Training and CPR/First aid training reviewed and up-to-date. All staff are background cleared and associated to the licensed location accurately. Disaster drills are conducted quarterly. 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. An exit interview was conducted and a copy of this report along with appeal rights was provided to a facility representative.