Routine inspection·August 20, 2024

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required annual inspection. LPA was greeted by staff and granted entry. LPA met with Administrator Fez Jon and explained the reason for the visit. The Administrator's certificate expires on April 7, 2026. Facility is a one story home with 6 bedrooms, 5 bathrooms, living room, kitchen, dining room, 2 staff rooms and a 2 car garage. Facility is licensed for 6 non-ambulatory residents of which 6 can be bed ridden and a hospice waiver for 3. There is a screened fireplace in bedroom 1. LPA observed the See Something, Say Something Poster (PUB 475) posted in the main entry way of the facility. LPA and staff toured the facility. LPA observed all resident bedrooms had the required furnishings and bed linens. LPA observed the kitchen is clean and organized. LPA observed a 2 day perishable and a 7 day non-perishable food supply on hand in the kitchen. Knives are kept locked in a kitchen drawer. LPA observed the 4 burner gas stove lights unassisted. LPA observed the fire extinguisher in the kitchen is fully charged. LPA observed medications are kept locked in the hall closet. All 5 bathrooms are clean and operational. Hot water measured 108.0 to 110.0 degrees Fahrenheit in all 5 bathrooms. LPA observed a clean supply of linens and towels in the hall closet. LPA and staff toured the garage. The garage is kept locked. Cleaning supplies and emergency food and water are stored in the garage. LPA and staff toured the backyard. There is a covered patio that provides shaded seating. No bodies of water observed. The exit gates on each side of the house are operational. Smoke detectors/carbon monoxide detectors tested operational. Facility has a tablet that can connect to the internet for resident use. The last facility fire drill took place June 1, 2024. Administrator Fez Jon left the facility during the visit due to an previously scheduled appointment. LPA reviewed 2 staff files. LPA observed Staff 1 (S1) did not have the required 20 hours of annual training. Both staff files reviewed had current CPR training. LPA reviewed 6 resident files, no discrepancies observed. LPA reviewed 6 resident medications, no discrepancies observed. LPA inspected the first aid kit. The first aid kit has all required elements. Deficiencies are being cited per Title 22 Division 6 of the California Code or Regulations. An exit interview was conducted and a copy of the report provided along with appeal rights.