Routine inspection·December 14, 2024

Licensing Program Analyst (LPA) Christian Gutierrez conducted the annual inspection using the Compliance and Regulatory Enforcement (CARE) tools. LPA met Caregiver Melgasbal (Mel) Manuel at approximately 8:15 AM and explained reason for visit. Administrator Maria Mirabueno was notified by telephone. The facility is licensed for 6 non-ambulatory residents. The facility has a Hospice waiver for 3 residents. The facility is in a residential area, and it is a one-story family home. A tour of the single-story facility included the living room, kitchen, dining room, five (5) resident bedrooms, three (3) bathrooms, front yard, backyard, and attached garage. LPA toured the facility and observed the following: Each resident bedroom has the required furniture and bedding. There is extra clean linen and towels in hallway closet. Smoke detectors/carbon monoxide detectors were observed in each room and throughout the facility and are properly operating. The facility has one (1) fully charged fire extinguisher which is kept in kitchen. Cleaning supplies and toxic substances are inaccessible locked in cupboards in kitchen. Freezers are maintained at a temperature of 0-degree F and the refrigerators at a maximum of 40 degrees F. Sufficient supply of 2 days perishable & 7 days non-perishable foods was observed in the kitchen. There are no firearms or weapons stored at the facility. The hot water temperature in the bathrooms were measured between the required range of 105-120 degrees F. Bathrooms had required grab bars and nonskid mats. The facility does not have a swimming pool or bodies of water on the premises There is a shaded seating area for the residents located in the backyard. Passageways and exits are free of obstruction. SEE LIC 809C Three (3) staff files were reviewed and included Criminal clearance record, CPR/training, and health screening with TB. Five (5) residents files were reviewed and included physicians report, TB clearance. Last fire/earthquake drill was conducted in September of 2024. Infectious control plan will be emailed to LPA. Two (2) staff and (1) resident was interviewed. Five (5) resident medications were reviewed. Medications are centrally stored and locked MAR log is used. No deficiency was observed during today’s visit. Exit interview was conducted with Caregiver and a copy of report was provided.