Routine inspection·December 23, 2024

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. At around 8:00 AM, LPA Tea was greeted and granted entry into the facility by caregiver Romualdo Peleno and explained the reason for the visit. Administrator (AD) Rico Almiranez arrived shortly to assist with the visit. Facility is licensed for 6 non-ambulatory residents, of which one may be bedridden, with a hospice waiver for five. Currently there are six residents during today's visit. At 8:25 AM, LPA Tea reviewed six resident files and three staff files. Residents’ files and staff files contained all required documentation. With the exception with one resident who has dementia in which the staff is currently having problems with the VA hospital to obtain a current medical assessment. AD Rico’s administrator certificate expires on April 10, 2026. LPA Tea along with the Administrator toured the facility at 9:39 AM. LPA toured the physical plant, checked food service, and the first aid kit. The facility is a one story home that has of 6 resident bedrooms, 1 staff room, 2 full bathrooms, living room, dining room, and kitchen and attached garage. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms are operational. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 111.3 F degrees and 112.2 F degrees. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards, doorways were free of obstructions. First aid kit had all the required elements including bandages, tweezers, thermometer, and scissors. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. LPA observed sharps locked in a kitchen drawer. LPA also observed toxin substances to be secured and locked and inaccessible to clients in the kitchen underneath the sink and a designated cabinet. The fire extinguisher in the kitchen is fully charged and last serviced on March 19, 2024. Annual Inspection continued on LIC809-C The facility’s last fire drill was conducted on November 21, 2024. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and there is ample seating with shade and the exit gate on the left side of the house is self-latching and operational. The backyard has a small garden area. There is a BBQ grill that a resident uses every other week to entertain and dine residents. LPA observed emergency food in the pantry by the kitchen and emergency water supply in the garage. Facility offers activities to residents based on personal preferences. Residents play bingo and do art. They go on outings on occasions like to watch movies. At the time of the visit, residents were watching television, having breakfast and enjoying Christmas music. At 10:00 AM LPA reviewed medication storage and administration. Medications are stored in a locked cabinet. Medications are being administered per physician order. LPA interviewed clients regarding their quality of care and spoke to staff present regarding care provided. Based on the observation made during today’s visit, no deficiencies were noted today in the areas inspected per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with administrator, Rico Almiranez and a copy of this report LIC809, 809-C, LIC858, LIC859, and LIC9102TV was read and provided to the facility.