Routine inspection·March 21, 2022

Licensing Program Analysts (LPAs) Kevin Saborit-Guasch and Claudia Gutierrez made an unannounced visit to the facility in order to conduct a required annual inspection. LPAs arrived at facility, were greeted and granted entry by Felijun Casayou, caregiver after explaining the purpose of the visit. Administrator Maria Tente was called on the phone but was unable to assist with the visit in person. At approximately 2:35pm, LPAs accompanied by caregiver toured the inside and outside of the facility. There are currently four (4) residents in care, one of (1) of which is currently on hospice. Residents are observed to be relaxing in their bedroom or in the common areas are appear well taken care of. The bedrooms include all necessary components and sufficient quantity of linen is observed also. Both bathrooms are equipped with grab bars and slip mats. The kitchen drawer in which sharp instruments are stored is observed to have a non-functional magnetic lock. The door leading to the garage is also left open during the daytime in spite of the presence of cleaning supplies and detergent there. Caregiver indicates that it is being locked at night only. LPAs observed the facility has COVID-19 Precautions posters and required department postings. Administrator licenses for Nelson Acsay, Maria Tente and Ina Czarina Chua are posted by are all outdated. Facility has an adequate supply of PPE and emergency supplies. A LIC808 Mitigation has been submitted on 02/23/2021. LPA observed a sufficient supply of food and water. A 30-day supply of medication is centrally stored under lock. Daily/weekly pillboxes are observed in front of the cupboard with pills left in them. LPAS advised caregiver to store pillboxes inside the locked compartment as well. LPAs toured the outside of the facility. Outdoor furniture is present for the residents' enjoyment in the backyard. The gates on the side of the house are self-latching and can easily be opened in an evacuation. A swimming pool in the backyard is observed to be adequately fenced and equipped with a self-latching gate. Based on the observations made during today’s visit, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. A Technical Advisory is also issued in regards to the outdated licenses, lock on the swimming pool gate, unlocked pillboxes and unlocked garage door. This report was reviewed with facility representative and a copy of this report and appeals right was provided and left at facility.