Routine inspection·June 2, 2025

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry by facility administrator Emiliana Pinera after stating the purpose of the visit. There are currently three residents in care, none of which are receiving hospice care at this time. LPA observed residents relaxing in the facility's common living areas or in their respective bedrooms. LPA accompanied by facility staff toured the physical plant. The facility is a one-story house with an attached garage. The facility has four bedrooms along with one locked staff room along with two shared bathrooms and one en-suite bathroom off of a shared room which currently only houses one occupant. Bedrooms appear clean and sanitary. Two residents are observed using half-rails postural supports at the time of the visit, consultation provided and licensee instructed to submit adequate physician orders at the earliest convenience. All resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary and are equipped with grab bars and slip mats. Hot water temperature measured at 111F in two separate bathrooms equipped with faucets used for personal grooming. LPA observed the kitchen has a minimum two (2) day perishable and seven (7) day non-perishable food supply. Sharp items, cleaning supplies and the medication central storage are verified to be secured. The wall-mounted fire extinguisher is charged with up-to-date maintenance. Smoke and carbon monoxide detectors were found to be operational. The garage is inaccessible to residents and used for laundry as well as additional storage of supplies. CONTINUED ON FORM LIC809-C CONTINUED FROM LIC809 LPA and facility staff toured the outside of the facility. LPA observed a shaded outdoor seating area with furniture for resident use. There are two self-latching gates on each side of the property. One gate was damaged off its hinge during a facility renovation and is scheduled for repairs. The identified route of egress is however free of clutter and obstructions. There are no bodies of water on the premises. Facility does not utilize locked perimeters or delayed egress. LPA reviewed three resident records which included all necessary components. Consultation provided on regular physician assessments. One resident self-administers their own weekly Ozempic injection and is able to self-administer per staff assessment. Their physician report however needs to be updated as soon as possible as the assessment does not corroborate the resident's current condition. LPA reviewed resident medication records and prescription orders for all residents with no discrepancies observed. Oxygen is currently in use on the premises with adequate signs observed. There are no residents currently assessed as being bedridden at the time of the visit. Resident interviews were conducted or attempted during the visit along with staff interviews. LPA reviewed staff records for two staff members present during the visit. Present staff member has a current CPR certificates on file, however administrator Emiliana Pinera also provides care and covers the overnight shift. CPR training for Mrs. Pinera has lapsed. Type B citation issued. Annual training on file, consultation provided on the need to document dates for annual and initial staff training. Disaster drills are conducted however they are not held quarterly nor documented. Type B citation issued. Both staff members present are background cleared and associated to the licensed location. Based on the observations made during today’s visit, two type B 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 along with appeal rights were provided to a facility representative.