Routine inspection·March 22, 2023

Licensing Program Analysts (LPA ) Lydia Martinez made an unannounced Required - 1 Year inspection. LPA met with Lead Staff Susana Garcia and stated the purpose of this visit. Administrator (AD) Divina Alipio arrived shortly after and provided assistance. The facility is a single level 4-bedroom, 2 bathroom home with an attached garage. Facility is licensed for six non-ambulatory. This facility offers a Level IV service. LPA Martinez, along with Carestaff Garcia conducted walk through of inside and outside of the facility. LPA observed four clients in care and three staff members on duty. Two clients were at Program. There were four Client rooms to which two are double occupancy. Two Clients were watching TV in living room; two others were in their rooms. Clients appeared clean and happy. Client rooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Facility has hourly staff - (no live-in). Smoke detectors are centrally wired, Carbon Monoxide, and Auditory Exit Alarms were tested and were operational. Bathrooms were observed to be in good repair and provided with grab bars, non-skid matt, paper towels and toilet paper. Hot water in Client's bathrooms was measured at 108.2 degrees F. Kitchen is in good repair with knives kept locked. Facility met the minimum two day supply of perishable and seven day supply of non-perishable food stock requirements. Cleaning supplies and sharp items were inaccessible to the Clients in care. Facility had adequate supplies of personal protective equipment in place. Fire extinguishers were observed and charged. For the exterior portion, the facility had an outside covered patio with furniture and in good repair; and grounds were free of tripping hazards. Laundry room was in good repair and First Aid Kit observed contained all required items. P&I records; each client's balance matched with the ledger account and the funds were accurate. Facility conducted it's last emergency drill on 12/22/2022. (cont on LIC809C) Client Records/Incident Reports/Personal Rights/Residents with Special Needs/Incidental Medical and Dental - LPA reviewed 3 client files. LPA noted Admission Agreement, Medical Assessment and TB test results, Identification and Emergency information, Individual Program Plan, Consent forms, Centrally Stored Medication/Destruction Records, Safeguard for Personal Property/Valuables, and Personal Rights Notification. Personnel Records/Training/and Staffing- 3 records were reviewed. LPA reviewed employee records for First Aid certification, Finger Print Clearance, Personnel/Job Application, Health Screening and TB test results, Criminal Record Statement, Employee Rights, Training Verification, and current Administrator Certification, which expires on 06/19/2024. Based on the observations made during today’s inspection, 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 will be sent to the email on file.