Routine inspection·August 25, 2022

Licensing Program Analyst (LPA)Andrea Mendivil conducted an unannounced visit for the purpose of conducting a required/ annual visit. LPA was greeted and granted entry into the facility by Caregivers JR Reblora and Susan Pineda and explained the reason for the visit. During visit Administrator Saba Tesfay arrived at at 12:18 PM. At 11:30 AM, LPA toured the facility with Caregiver Susan Pineda. Facility is 5 bedroom, 3 bathroom single story home with a detached garage. Facility has 6 residents present during today's visit. LPA observed residents eating lunch in dining room. Facility appears clean and sanitary. All residents rooms had the required elements as well as restrooms stocked with soap/ sanitizer. LPA observed bed rails on 5 out of 6 resident's beds without physician orders. The facility mitigation plan has been completed and approved. LPA observed emergency food and water. LPA observed locked medication cabinets. LPA toured the outside grounds and observed outside shaded visitation area. Exit gate is unlocked and self latching. Facility has a plan for covid testing residents and staff as needed as well as a plan for isolation. LPA reviewed all residents files and all contained required documentation including updated emergency information. All staff and residents are vaccinated for Covid 19. Based on the observations made during today’s visit, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with the facility representative and a copy was provided as well as appeal rights.