Routine inspection·April 17, 2025

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 1:38 PM, LPA Tea was greeted and granted entry into the facility by the caregiver staff. Administrator (AD) Geraldine Doan arrived shortly to assist with the visit. Facility is licensed for 6 non-ambulatory residents, with a hospice waiver for six and one maybe bedridden in Bedroom #1. Currently there are four residents, and two are on hospice during today's visit. At 1:48 PM, LPA Tea reviewed four resident files and two staff files. Residents’ files and staff files contained all required documentation. Administrator certificates expire on September 27, 2026. LPA Tea along with AD Doan toured the facility at around 2:30 PM. LPA toured the physical plant, checked food service, and the first aid kit. The home consists of 5 resident bedrooms, which one room is shared, 2 staff room, 2.5 bathrooms, a living room, a family room, a dining room, 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 around 109.4 Fahrenheit degrees to 113.1 Fahrenheit 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 dressing, 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 secured in a locked drawer. LPA also observed toxin substances to be secured and locked and inaccessible to clients underneath the kitchen sink Annual Inspection continued on LIC809C and garage. The fire extinguishers through out the facility are fully charged. The facility’s last fire drill was conducted on February 12, 2025. Kitchen appliances are operational during today's visit. LPA observed emergency food and water supply in a locked closet by the kitchen. LPA toured the outside grounds and there is ample seating with shade and an exit gate on the left side of the house that is self-latching and operational. In the backyard there is a unused small pool that is secured by a locked gate. There is also a barbecue grill that is often used in the summer. Facility provides activities based on resident's personal preference. The residents like to read and do exercises. At the time of the visit, LPA observed residents reading and doing some puzzles.. At 3:00 PM LPA reviewed medication storage and administration. Medications are stored in a locked cabinet by the kitchen. 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 Geraldine Doan and a copy of this report LIC809, 809-C, LIC858, LIC859, was read and provided to the facility.