Routine inspection·December 16, 2024

On December 16, 2024, Licensing Program Analyst (LPA's) Jenifer Tirre and Eboni Bentley conducted an unannounced required visit using the CARE Inspection Tool. LPA's were greeted by staff and granted entry after stating the purpose of the visit. Administrator (Admin) Cherry Parungao was present to assist with the facility inspection on today's date. The facility is licensed for five (5) non-ambulatory residents, (1) bedridden with approved hospice waiver for three (3) residents. This is a single story with a two-car garage facility. The facility has five bedrooms (four resident bedrooms and one staff bedroom) and two bathrooms. At around 10:00 AM, LPA's conducted a tour of the physical plant accompanied by Administrator Cherry Parungao, and the following was observed: There were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in operational condition, lighting was provided, and storage for the client's personal belongings was observed. Bed linens, comforters, and bath towels were available during the visit. Bathrooms were operational with water temperature measured at 112.4 degrees F. A comfortable temperature of 70 degrees F. was maintained in the facility. LPA's observed the facility to be furnished at the time of the visit. Storage areas for personal hygiene and cleaning suplies were stored and not accessible to residents. The kitchen was inspected, and sufficient perishable and non-perishable food was maintained adequately. Facility has one fire extinguisher,which was mounted and was charged. A review of the Medication Records Administration (MAR) was conducted, and LPA's observed the records are in compliance. CONTINUED ON 809C During the visit, LPA's observed the facility's infection control practices. LPA's observed screening protocols for visitors, staff, and residents. LPA's observed the facility has a supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. LPA observed First Aid Kit was maintained. A working land line phone was operational. The last fire drill was conducted on September 10, 2024. The facility had operational smoke and carbon monoxide in bedrooms and common areas. The facility has current liability insurance on file effective September 19, 2024 - September 19, 2025. A review of four residents (R1-R4) service files and three staff (S1-S3) personnel files revealed to be complete. The facility has current administrator listed as Maria Parungao and certification is listed as pending renewal for August 12, 2024. Facility has supply of emergency food and water. Based on the observations made during today's visit, the following deficiencies are being cited as per the Title 22 Division 6 Chapter 2 of the California Code of Regulations. An exit interview was conducted, and a copy of this report and appeal rights were provided to Administrator Maria Cherry Parungao.