Routine inspection·March 23, 2024

Licensing Program Analyst (LPA) Celine De Perio conducted an unannounced visit for the Required 1 Year Inspection. LPA explained the purpose of today’s visit, and was greeted and granted entry by licensee (LE) Irene Wong-Samson. For today’s visit, LPA observed a total of 6 residents in care and 2 staff members on duty. LPA observed the Administrator's Certificate for facility administrator (AD) Oscar Samson which expires on 1/13/2025. LPA De Perio toured the interior and exterior portions of the facility with S1 Granada. The facility is a single level structure and is licensed for 6 residents. For this visit, there are a total of 6 residents in care. There are a total of 5 bedrooms, of which 2 is a private resident room, 2 are shared resident rooms, and 1 room designated for staff. LPA De Perio toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. It was observed that there are a total of 3 restrooms in the facility. Restrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature in restrooms were measured to be at 108.2 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to residents in care. Fire extinguisher was charged, mounted and located in the hallway. LPA De Perio observed the emergency disaster and evacuation plan, which is posted in the hallway and in a binder. Facility had back-up emergency food and water supply, located in the garage and in the kitchen. LPA De Perio observed that First Aid Kit had all the required components. LPA De Perio observed that medications and toxins were locked and inaccessible to residents in care. For the exterior portion, LPA De Perio observed patio furniture under shading, and the grounds were free of any hazards. There are 2 gates in the backyard, which both were self-closing and self-latching. No bodies of water were observed. For today's visit no deficiencies were issued per Title 22 Division 6 of the California Code of Regulations. No citations were issued. An exit interview was conducted with LE Wong-Samson. A copy of this report was provided and explained.