Routine inspection·March 23, 2024

Licensing Program Analyst (LPA) Celine De Perio conducted an unannounced required annual inspection. LPA De Perio explained reason for visit and was greeted and granted entry by facility administrator (AD) Mary Jean Catacutan. For this visit, LPA observed 5 residents in care, of which 3 are on hospice, and 3 staff members on duty. LPA observed the Administrator's Certificate for Mary Jean Catacutan, which expires on 8/2/25. PUB475 "See Something, Say Something" poster was also observed to be posted in the kitchen. LPA De Perio toured the interior and exterior portions of the facility with AD Catacutan. The facility is a two level structure and is licensed for 6 non-ambulatory residents, of which 3 may be on hospice. On the first floor, there are a total of 5 bedrooms, of which 4 are private resident rooms and 1 shared resident room. On the second floor, there are 2 bedrooms designated for staff. LPA observed and verified that there are no residents residing on the second floor. LPA De Perio toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. There are a total of 3 bathrooms on the first floor for resident use, and 1 bathroom on the second floor designated for staff. Restrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature in restrooms were measured to be at 113.1 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to residents in care. Fire extinguisher was charged, mounted and located in the kitchen. LPA De Perio observed the emergency disaster and evacuation plan, which is posted in the hallway. Facility had back-up emergency food and water supply, located in the kitchen and in the garage. LPA De Perio observed that First Aid Kit had all the required components. Medications and toxins were locked and inaccessible to residents in care. For the exterior portion, LPA De Perio observed patio furniture under shading, and the grounds were free of any hazards. There are 2 gates in the backyard, which both were self-closing and self-latching. No bodies of water were observed. For today's visit no deficiencies were issued per Title 22 Division 6 of the California Code of Regulations. No citations were issued. An exit interview was conducted with AD Catacutan. A copy of this report was provided and explained.