Routine inspection·June 12, 2025

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. At around 8:41 AM, LPA Tea was greeted and granted entry into the facility by caregiver staff and explained the reason for the visit. Administrator (AD) Amy Zuehl arrived shortly to assist with the visit. Facility is licensed for six non-ambulatory residents; one may be bedridden with a hospice waiver for six. Currently there are six residents, of which one is on hospice during today's visit. LPA Tea reviewed six resident files and two staff files. Resident files and staff files contained all required documentation. Administrator certificate expires on August 03, 2025. LPA reminded AD Zuehl that her certificate is going to expire soon. She acknowledged that she has completed all course work and submitted everything already. LPA Tea along with AD Zuehl toured the facility at 9:50 AM. LPA toured the physical plant, checked food service, and the first aid kit. The home consists of five resident bedrooms, a staff room, two bathrooms, living room, family room, dining room, kitchen, laundry room and an attached garage. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms are operational. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 107.6 F degrees and 108.5 F degrees. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards, and doorways were free of obstructions. First aid kit had all the required elements including dressing, bandages, tweezers, thermometer, and scissors. Kitchen was inspected. Perishable and non-perishable food supply were checked and adequately stocked at time of visit. LPA observed sharps locked underneath the kitchen sink. LPA also observed toxin substances to be secured and locked and inaccessible to clients underneath the kitchen sink and the laundry room. The fire Annual inspection continued on LIC809-C extinguisher in the kitchen is fully charged. The facility’s last disaster drill was conducted in February 15, 2025. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and there is ample seating with shade and there are two exit gates on both sides of the house that are self-latching and operational. The backyard has a shaded patio area for clients to sit. There are various plants and fruit trees in the backyard garden, sometimes the residents come outside to enjoy the weather. LPA observed emergency supplies, food and water in the garage. LPA noted that the facility’s emergency water was really low. LPA reminded AD Zuehl there needs to be enough for residents and staff in case of emergency. Activities are based on resident’s personal preference or health condition. Facility provides activities like physical therapy and exercises. At the time of the visit, LPA observed residents eating breakfast and watching television. LPA then reviewed medication storage and administration. Medications are stored in a locked closet in the facility. Medications are being administered per physicians order. LPA interviewed residents regarding their quality of care and spoke to staff present regarding care provided. Based on the observation made during today’s visit, no deficiencies were noted today in the areas inspected per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with the facility and a copy of this report LIC809, 809-C, LIC858, LIC859, LIC9102 was read and provided to the facility.