Routine inspection·March 17, 2025

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to the facility today to conduct an Annual Required Evaluation. LPA was greeted and granted entry by Lisa Gaitan, Administrator. The facility is a five bedroom, two bathroom, single story residence with an approved fire clearance of six non-ambulatory residents with a hospice waiver for six. The facility currently has a census of six residents in care with two on hospice. During today’s visit, LPA toured the facility and inspected the physical plant, including but not limited to testing all smoke detectors and testing hot water temperature in two of two resident bathrooms. The hot water temperature measured between 119.1 to 119.7 degrees Fahrenheit and all smoke detectors were operational . Resident bathrooms had grab bars and non-skid mats with covered trash cans. The fire extinguisher is charged and was serviced on June 4, 2024. The facility’s last fire drill was conducted on January 8, 2025 . LPA inspected the facility food supply and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand. Knives and cleaning solutions were secured in the garage LPA observed medication storage and reviewed the centrally stored medications. Per review of medications, it is not clear if they are being given as prescribed. LPA advised Administrator to use the digital Adivantus system to inventory and account for medications. An LIC 809-D will be given. LPA toured the exterior of the facility and noted a shaded seating area and various seating areas in the backyard. There are no obstructions in passageways and the exterior gate is self-latching. LPA observed residents in the common area watching a movie. Residents were going to celebrate a St. Patrick's day dinner later in the day. (Continued on LIC 809-C) (Continued from LIC 809) LPA reviewed t hree of three staff training and fingerprint records and conducted a complete review of resident records. Staff #1 was not fingerprint cleared and was told to leave the premises. Guardian documentation showed prior fingerprints were incomplete and expired on March 2, 2025. A Civil Penalty will be given for $100 per day X 5 days on a LIC 421-BG. Staff #1 will re-submit fingerprints and cannot return to work until they are cleared. LPA interviewed alert residents regarding their quality of care and spoke to staff present regarding care provided. LPA confirmed that administrator has a current administrator certificate, which is pending, and will expire on December 23, 2026. The following deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with Lisa Gaitan, Administrator and a copy of this report was given to the facility along with a copy of the LIC 858, LIC 859; LIC 809-D and Appeal Rights.