Routine inspection·March 23, 2024

Licensing Program Analyst (LPA) Celine De Perio conducted an unannounced required annual inspection focusing primarily on the Infection Control. LPA De Perio explained reason for visit and was greeted and granted entry by house manager (HM) Felijun Casuyon. LPA observed the administrator certificate for Maria Tente, which expires on 12/3/2024. The PUB475 "See Something, Say Something" poster was also observed to be posted at the entrance. Facility is licensed for 6 non-ambulatory residents, of which 2 may be on hospice. During this visit, there are a total of 5 residents in care, of which 2 are on hospice and 2 staff on duty. LPA De Perio toured the interior and exterior portions of the facility with HM Cauyon. The facility is a two level structure. On the first floor, there are a total of 5 bedrooms, of which 4 are private resident rooms, and 1 shared resident room. On the second floor, there are a total of 3 bedrooms, of which are only for staff. During this visit, LPA observed and verified that there are no residents residing on the second floor. 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. On the first floor, there are a total of 4 bathrooms for residents, and 1 bathroom on the second floor for staff. 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 107.7 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 kitchen. LPA De Perio observed the emergency disaster and evacuation plan, which is posted in the living room. Facility had back-up emergency food and water supply, located in the kitchen and in the garage. LPA De Perio observed that First Aid Kit had all the required components. Medications and toxins were observed to be locked and made 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 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 HM Casuyon. A copy of this report was provided and explained.