Routine inspection·March 7, 2025

Licensing Program Analyst (LPA) Nancy Guillen made an unannounced visit for the purpose of conducting a required annual Inspection. LPA was greeted and granted entry by caregiver Hendrick Catayas after explaining the purpose of the visit. Administrator (AD) Rita Lee was notified and assisted via telephone. LPA observed the Administrator Certificate was current and expires July 31, 2026. This is a Residential Care Facility for the Elderly (RCFE) licensed to six non-ambulatory residents, of which three may be bedridden, with a hospice waiver for four. The facility is a two-story home. The first floor consists of five resident bedrooms, three resident bathrooms, a family room, dinning room, kitchen and garage. The second floor is for staff and consists of three staff bedrooms, one bathroom and a vanity room. During the inspection, LPA and caregiver Hendrick Catayas toured the inside and outside of the facility, common areas, resident rooms, kitchen, garage and observed the following:LPA observed residents watching television in their respective rooms and sitting in the dinning table. LPA observed five residents in care and two staff present. LPA observed the See Something Say Something Poster (PUB 475) mounted on the wall by the entrance to the facility. LPA observed knives to be located in an unlocked drawer in the kitchen; a deficiency was cited on today’s date. All resident bedrooms had the required furnishings. LPA observed four out of five residents had bed rails with no doctor’s orders present at the facility; a deficiency was cited on today’s date. Resident 2 had a camera in his bedroom; a deficiency was cited on today’s date. LPA observed all resident beds had linens and blankets with additional linens stored in Room 1. LPA observed bathrooms were clean and equipped with grab bars and non skid floor mats. LPA observed all windows were appropriately screened. Bathrooms were observed to be free of debris and mildew, faucets and toilets were tested operational. Water temperature tested between 110.8 and 125.6 degrees Fahrenheit; a deficiency was cited on today’s date. LPA toured the outside of the facility and observed outdoor passageways were free of obstruction. LPA observed the backyard had a shaded sitting area with furniture for resident use. Continued on 809C LPA observed the facility had a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Smoke detectors tested operational, however a carbon monoxide detector was not located at the facility; a deficiency was cited on today’s date. Fire extinguisher was observed to be fully charged with a service date of February 20, 2025 and located in the family room. Gas stove, microwave, washer, and dryer were all inspected and observed to be operable. Toxic chemicals, cleaning solutions, and disinfectants were observed to be locked and inaccessible to residents under the kitchen sink. Medication cabinet was observed to be locked and centrally stored in the kitchen however, PreserVision and Iprat-Albut was being administered to residents without a doctor’s order present at the facility; a deficiency was cited on this date. LPA observed the First Aid Kit had all the required components. LPA observed the facility conducted their last emergency disaster drill on August 2, 2024; a deficiency was cited on today’s date. Liability insurance was not present at the facility; a Technical Violation was given on today’s date. LPA began review of the records. LPA reviewed five resident records. One out of five records reviewed was missing a Physician’s Report and an admissions agreement and three of the five records reviewed were missing negative TB tests; deficiencies were cited on today’s date. LPA reviewed three employee records. All employee’s present have a criminal record clearance and were associated to the facility. However, all staff CPR certifications were observed expired ; a deficiency was cited on today’s date. Two of the staff present today did not have a negative TB test present at the facility; a deficiency was cited on today’s date. Based on the observations made during today’s inspection, 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 and appeal rights was left at the facility.