Routine inspection·July 18, 2024

Licensing Program Analyst (LPA) Jessica Cho arrived at the facility unannounced for the purpose of conducting the Required 1-Year annual inspection using the CARE Inspection Tool. LPA met with Licensee/Administrator Shimon Cagan and explained the reason for the visit. The facility is a two story structure located in a residential neighborhood. Facility is licensed to operate for six (6) non-ambulatory and maintains a hospice waiver for four (4). There are five residents in care during today's visit with two caregivers on duty. LPA observed the facility to be clean and sanitary. There are five resident bedrooms and two resident bathrooms. All common areas were inspected including the attached two car garage and the sun room which doubled as a laundry room. The residents' bedrooms were appropriately furnished. Beds and bedding supplies were in good condition, adequate lighting was provided, sufficient storage space for each residents' personal belongings were observed. Bathrooms were found to be in compliance, clean, and operational. The water temperature measured at 113.3 and 109.2 degrees Fahrenheit. Toxins, disinfectants, sharps, and medications were secured and inaccessible. LPA observed sufficient two-day supply of perishables and seven-day supply of non-perishable food available. LPA toured the exterior portion of the facility. LPA observed the outdoor passageway free of obstructions. The exit gate was self-closing and self-latching. LPA observed sufficient seating and shading. Facility maintains two fire extinguishers. Both were mounted, charged, and serviced on March 12, 2024. The auditory devices and dual-functioning smoke/carbon monoxide detectors were tested and operational. LPA observed the emergency disaster supplies including food/water in the garage. Emergency evacuation drills are being conducted quarterly. The first aid kit contains all necessary elements. A working facility telephone number, 714-542-0382, remains available. LPA observed the required 'See Something, Say Something' (PUB475) poster in the correct size posted in the entry way. The Administrator's Certificate for Shimon Cagan expires on November 21, 2025, August 21, 2024 for Administrator Seth Curkin, and October 11, 2024 for Bonnie Curkin. LPA conducted an audit of five residents' files and two personnel files. No discrepancies were noted. Staff and resident interviews were conducted. Medications were audited for five residents. No discrepancies noted. Based on the observations made during today's visit, no deficiency is being cited today. An exit interview was conducted with Licensee/Administrator Shimon Cagan, and a copy of this report was provided at the end of the visit.