Routine inspection·October 19, 2023

This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of conducting a Required – 1 Year Inspection. LPA met with Staff #1 (S1) Gladis Pachuca and discussed the purpose of the inspection. Administrator (AD) Fredric Robart arrived during the inspection. LPA reviewed Infection Control requirements. At about 1:00PM, LPA and S1 conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, and garage and observed the following: Structure: this is a one-story home. Facility is a 6-bedroom, 2-bathroom, one-story house with detached garage that is being used for storage. LPA observed 3 staff and 6 residents present at the facility. Resident Bedrooms: the 4 resident bedrooms are spacious and will easily accommodate the residents’ furnishings. Furniture for each resident bedroom inspected. Staff Bedrooms: LPA inspected the 2 staff bedrooms. Bathrooms: the bathrooms were clean, faucets and toilets were operational. Water temperature: tested at 110 degrees F in the client bathroom near the backyard and 116 in the client bathroom near the front door. LPA inspected all rooms in the facility. Linens & Hygiene Supplies: new linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu: reviewed. Food Service: LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food is available as required by regulations. Carbon Monoxide, Smoke Detectors, Fire Extinguisher: observed and tested, including the wired smoke detectors/carbon monoxide detectors. Appliances: stove burners, microwave, washer, and dryer inspected. Knives: observed locked in the kitchen. Toxins: observed locked in the kitchen and in the garage. Medication cabinet: observed to be locked. First-Aid Kit and Activity Supplies: observed and available. AD paid the facility’s licensing fees during the inspection. At about 2:00PM, LPA reviewed 6 resident files and 5 staff files, interviewed 6 residents and 3 staff, inspected medications for 6 residents, and inspected resident money and ledgers for 6 residents. There were no deficiencies observed in the areas inspected. Based on the observations made during today’s inspection, 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 was discussed with and provided to facility representative.