Routine inspection·January 6, 2025

This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of conducting a Required – 1 Year Inspection. LPA met with staff Marissa Acerbo and discussed the purpose of the inspection. Administrator (AD) Darlyn Colesio arrived during the inspection. LPA reviewed Infection Control requirements. At about 12:30PM, LPA and staff Acerbo conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, and garage and observed the following: Structure: facility is a 6-bedroom, 3-bathroom, two-story house with an attached garage that is used for storage. There is a back yard with a patio cover for the residents and a pool that is properly gated. LPA observed 4 staff and 4 residents present at the facility. Resident Bedrooms: the 3 resident bedrooms are spacious and will easily accommodate the residents’ furnishings. Furniture for each resident bedroom inspected. Staff Bedrooms: LPA observed three staff bedrooms on the second floor. Bathrooms: the bathrooms were clean, faucets and toilets were operational. Water temperature: tested 117 degrees F in the resident bathroom. Linens & Hygiene Supplies: new linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu: reviewed. Food Service: LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food is available as required by regulations. Carbon Monoxide, Smoke Detectors, Fire Extinguisher: observed and tested. Appliances: stove burners, microwave, washer, and dryer inspected. Knives: observed locked in the kitchen. Toxins: observed locked in the kitchen. Medication cabinet: observed to be locked. First-Aid Kit and Activity Supplies: observed and available. Facility’s licensing fees are paid. At about 1:30PM, LPA reviewed 4 resident files and 4 staff files, interviewed 4 residents and 3 staff, and inspected medications for 4 residents. Facility does not handle resident money. CONTINUED. During the inspection, LPA and AD observed the following: based on documents, the licensee did ensure Staff #1’s (S1) staff file contained documented evidence of the required 20-hour annual training; and based on documents and admission, Resident #1 (R1) is being given supplements including calcium with no doctor's orders on file and is not being given medications including Acetaminophen without discontinuation orders and Resident #2 (R2) was not given their iron and vitamin C supplements after December 2024 despite the doctor's order not being discontinued. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809D. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.