Routine inspection·June 19, 2024

Licensing Program Analysts (LPA) Jerome Haley conducted an unannounced visit to the facility to complete the required Annual inspection. LPA Haley met with Licensee/Administrator Larry Lindsey and toured the facility. The facility has a capacity of 6, of which 6 can be non-ambulatory and 1 may be bedridden. The facility phone number 714.202.5075. Structure : The facility is one level structure with six bedrooms. Currently five bedrooms are being occupied by residents and 1 bedroom is being occupied by staff. Kitchen: Sharps locked in a cabinet near the stove. A perishable food supply was observed in the refrigerator and freezer. Non-perishable food supply was observed in the cabinets. Stove/Appliances: There’s one stove with 4 burners and a warmer, a refrigerator, dishwasher, washer, and dryer. The top left burner, the warmer and the bottom right burner on the stove would not light unassisted. Toxins: All cleaning supplies and chemicals are locked in the garage. Medications, First-Aid Kit: Resident medications are locked in a closet near the front door. There’s a first aid kit in the kitchen. Resident & Staff Files : Resident and staff records are kept in a cabinet behind the dining room table. Bedrooms: Resident bedrooms were in compliance with regulation guidelines. Bathrooms: The bathrooms have working toilets, wash basin and shower. Grab bars were tightly secured to the walsl. Hot Water : Hot water was measured in the range of 115.8 – 119.1 degrees F. Continued on LIC809C Hygiene Supplies : The facility has an adequate supply of hygiene items available. Linens, Hygiene, Emergency Supplies: Additional linens for each resident are stored in a hallway closet. Emergency Evacuation Drills: The most recent evacuation drill was conducted March 1, 2024. Medication Review: There are currently five residents in the facility and medication was reviewed for all five residents. Resident File Review: A file review was completed for all five residents. Staff File Review: 3 staff files were reviewed during the visit. Garage: Walkways were free of obstruction. A washer and dryer was observed. A refrigerator and an additional supply of non-perishable items were observed Backyard: Clean, organized and walkways are free of obstruction. There's a table and chairs under a shaded patio area, and another table with a sunshade and chairs. Smoke Detectors/Carbon Monoxide Detectors: Smoke detectors and the carbon monoxide detector tested operational. There’s a fully charged fire extinguisher on the counter behind the dining table. Misc (P&I): N/A. The facility does not manage any of the resident’s money. Activities, Recreation, Reading Material, etc: Puzzles, word search, exercise balls, clay the residents use. Citation(s): Citations will be issued for violations observed during the inspection. After the citation was written for the stove and dishwasher in disrepair, it was discovered the dishwasher is in good working condition. The outlet that the dishwasher was plugged into was not providing power to the dishwasher. The stove still needs to be repaired or replaced. Exit Interview: Exit interview was conducted, and a copy of this report and appeal rights were provided to Administrator Larry Lindsey.