Routine inspection·June 14, 2024

On June 14, 2024 at 8:20am, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim met with Caregiver Maricel Neumann and explained the purpose of the visit. The facility is licensed to operate for six (6) non-ambulatory of which one may be bedridden and have a hospice waiver for four (4) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: five (5) resident bedrooms, one (1) staff bedroom, five (5) bathrooms, swimming pool, living room, dining room, kitchen, attached 3-car garage, and an outside covered patio area. LPA Kim toured indoor and outdoor of the physical plant with Caregiver Neumann. There are no obstructions on the premises. Swimming pool is enclosed by a fence that is found to be within Title 22 regulations. The swimming pool fence is self-closing and self-latching. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. All bedrooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, Resident Room 4, Resident Room 5, and Staff Room 1. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured at 113.0 degrees and 115.3 degrees F. A comfortable temperature of 74 degrees F was maintained in the facility. The facility has two (2) fire extinguishers that are charged and they were all serviced on August 4, 2023. Smoke detectors and carbon monoxide detectors were operable. A working telephone (714-602-7673) remains available. Evaluation Report Continues on LIC 809-C LPA Kim observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly. Emergency food, water, and supplies are stored in the garage. First Aid Kit contained all the necessary elements. During the visit, LPA Kim observed the facility's infection control practices, plan of operation, and screening protocols for visitors, staff, and residents. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). LPA conducted an audit of resident files (R1-R6), staff files (S1-S3. and medication and medication administration review were in order and complete. LPA Kim conducted resident interviews and staff interviews. Deficiencies were cited during this inspection visit according to the California Code of Regulations (Title 22, Division 6, Chapter 8). An exit interview was conducted, and a copy of this report was provided to Caregiver Maricel Neuman.