Routine inspection·May 12, 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 caregiving staff after after introducing himself and stating the purpose of the visit. Administrator Juan Reyes was notified of the visit via telephone and arrived later to assist. There are currently five residents in care, three 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. LPA accompanied by facility staff toured the physical plant. The facility is a one-story house with a detached garage. The facility has four private and one shared bedrooms along with one staff room. There are two shared bathrooms throughout the facility. Bedrooms appear clean and sanitary. Some of the residents are using half rails or full rails for postural supports. Adequate orders present in all files or hospice plans of care reviewed. All resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary and are equipped with grab bars and slip mats. Hot water temperature measured at 116F and 118F 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 supplies and the medication central storage are verified to be secured. CONTINUED ON FORM LIC809-C CONTINUED FROM LIC809 The two wall-mounted fire extinguishers are charged, with up-to-date maintenance tags attached. LPA tested the smoke and carbon monoxide detectors which were found to be operational. The garage is inaccessible to residents and used for laundry as well as additional storage of food and supplies. 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 five resident records which included all necessary components. LPA reviewed resident medication records and prescription orders for all residents with no discrepancies observed. Oxygen is currently in use with adequate signs posted. There are no residents currently assessed as being bedridden at the time of the visit. Three resident interviews were conducted during the visit along with staff interviews. LPA reviewed staff records for two caregivers present during the visit. Present staff members have current CPR certificates on file. Annual training is provided by one of the facility's hospice providers, with logs not on hand at the time of the visit. 2025 annual training logs will be provided by facility staff as soon as the provider sends them in. Disaster drills are conducted quarterly with proof of attendance provided. Both staff members present are background cleared. One staff member associated to the facility during the visit using paperwork on hand in staff records as they were only associated to another location operated by the licensee upon the start of the visit. 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 were provided to a facility representative.