Routine inspection·May 7, 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 administrator Dina Lucaciu after stating the purpose of the visit. There are currently four residents in care, two of which are receiving hospice care at this time. LPA observed residents relaxing in the facility's common living areas or in their respective bedrooms as well as receiving toileting care or hospice care during the visit. 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 along with one locked staff room. There are two shared bathrooms accessed in the hallways as well as multiple en-suite full and half bathrooms throughout the facility. Bedrooms appear clean and sanitary. One resident is currently using full length rails for postural support. Hospice plan of care reviewed and verified to include an order for the support. All resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary. Hot water temperature measured at 110F in two bathrooms with faucets used for personal grooming. 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 medication central storage all verified to be secured. The mounted fire extinguisher is charged, with up-to-date maintenance receipts present. LPA tested the smoke and carbon monoxide detectors which were found to be operational. The attached garage is inaccessible to residents and used for laundry as well as additional storage of food and supplies. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 LPA and facility staff toured the outside of the facility. LPA observed an shaded outdoor seating area with furniture for resident use. There are self-latching gates on both sides of the property and the routes of egress are free of clutter and obstructions. There are no bodies of water on the premises. Facility does not utilize locked perimeters or delayed egress. LPA reviewed four resident records which included all necessary components. LPA reviewed resident medication records and prescription orders for all residents with no discrepancies observed. Oxygen is not currently in use. There is one bedridden resident present on the premises and verified to be located in the bedroom currently identified as bedridden on the fire clearance. Another resident stays mostly in bed but is not bedridden at this time. LPA provided licensee with a consultation on updating the fire clearance to include two bedridden residents in the event of an unforeseen change in condition. LPA reviewed staff records for two caregivers on staff. All staff are background cleared and associated to the licensed location accurately, with current CPR certificates on file. 2024 annual training provided. 2025 training was recently conducted, proof of training to be provided by licensee at the earliest convenience. Disaster drills are conducted quarterly with proof of the two most recent drills provided. Based on the observations made during today’s visit, no 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 was provided to a facility representative.