Routine inspection·February 21, 2025

Licensing Program Analyst (LPA) Nancy Guillen made an unannounced visit for the purpose of conducting a required annual Inspection. LPA was greeted and granted entry by caregiver Mark Lopez after explaining the purpose of the visit. Licensee Wennie Earwood and Administrator(AD) Enkhtsetseg Bat-Amgalan were notified via telephone and later arrived to assist with the inspection. LPA observed the Administrator certificate was current and expires December 30,2026. This is a Residential Care Facility for the Elderly (RCFE) licensed to six non-ambulatory residents, of which one may be bedridden, with a hospice waiver for three. The facility is a one story home with five resident bedrooms, three bathrooms, and an attached garage. During the inspection, LPA and caregiver Mark conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, garage and observed the following: LPA observed residents watching television and resting in their respective bedrooms. LPA observed four residents in care and two staff present. LPA observed the See Something Say Something Poster (PUB 475) mounted on the wall by the entrance. All resident bedrooms had the required furnishings. LPA observed all resident beds had linens and blankets with additional linens stored in the garage. LPA observed bathrooms were clean and equipped with grab bars and non skid floor mats. LPA observed all windows were appropriately screened. Bathrooms were observed to be free of debris and mildew, faucets and toilets were operational. Water temperature tested between 109.4- 114 degrees Fahrenheit. LPA toured the outside of the facility and observed outdoor passageways were free of obstruction. LPA observed the backyard had a shaded sitting area with furniture for resident use. Continued on LIC 809C LPA observed the facility had a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Smoke detectors and carbon monoxide detectors tested operational. Fire extinguisher was observed to be fully charged and located by the kitchen. During inspection bedroom next to living room was observed to have an additional wall built that is not present in the facility sketch; a deficiency was cited on today’s date. Gas stove, microwave, washer, and dryer were all inspected and observed to be operable. Toxic chemicals, cleaning solutions, and disinfectants were observed to be locked in the garage and inaccessible to residents. Medication cabinet was observed to be locked and centrally stored in the living room. LPA observed the First Aid Kit had all the required components. LPA observed the facility conducted their last emergency disaster drill on February 05,2025 and is conducted every 3 months. LPA began review of the records. LPA Guillen reviewed four resident records. All the required documentation were present and current in the residents’ files reviewed. LPA reviewed three employee records. All employee’s present have a criminal record clearance and were associated to the facility. LPA observed records reviewed had a current First Aid certificate. Licensee was notified of pending fees due. Based on the observations made during today’s inspection, a deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report and appeal rights was left at the facility.