Routine inspection·June 10, 2024

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. LPA Tea was greeted and granted entry into the facility by caregivers, Arianne Vallestero and Queeny Sabobo and explained the reason for the visit. During today’s visit, LPA met with Beatriz Lapid, the administrator of the facility. Facility is licensed for 6 non-ambulatory residents, with a hospice waiver for four. Currently there are four residents, of which one is on hospice during today's visit. Around 10:52 AM LPA reviewed 2 staff files and training records. LPA reviewed four of four resident records. Residents files and staff files contained all required documentation. Administrator certificate expired on May 23, 2024 however administrator has complied with all course work and is pending renewal at this time. LPA Tea along with the Administrator toured the facility at 11:29 AM. LPA toured the physical plant, checked food service, and the first aid kit. The home consists of 5 resident bedrooms, 2 full bathrooms, living room, dining room, and kitchen. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms and 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 105.2 degrees F to 111.0 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 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 locked and inaccessible to clients in care underneath the kitchen sink. Fire extinguisher in the kitchen was fully charged. Kitchen appliances are operational during today's visit. Annual Report continuation on LIC 809-C LPA toured the outside grounds and there is ample seating with shade and the two exit gates on both sides of the facilities are self latching and operational. LPA observed emergency food and water supply in the garage. Residents participate in numerous activities such as puzzles, exercises, walking around the facility and the neighborhood. The residents like to lounge in the nice backyard. There is also gardening activities and music therapy as well. At 11:49 AM LPA reviewed medication storage and administration. Medications are stored in a locked cabinet. Medications are being administered per physician order. LPA interviewed residents regarding their quality of care and spoke to staff present regarding care provided. The following deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with Beatriz Lapid and a copy of these reports were given to the facility along with a copy of the LIC 858; 859;809-D, and Appeal Rights.