Routine inspection·May 19, 2025

On May 19, 2025, at 8:00am, Licensing Program Analyst (LPA) Eboni Bentley conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Bentley was greeted and granted entry by Caregiver (CG) Helen Carcino. Administrator (AD) Ray Santianez arrived at the facility a short time later and was present during the remainder of the visit. AD Ray Santianez has an administrator certificate with an expiration date of August 18, 2025. The facility is a single level structure, licensed for six (6) non-ambulatory residents of which one (1) may be bedridden and has a hospice waiver for six (6) residents. The home consists of the following: six (6) resident bedrooms, one (1) staff rest area, two (2) bathrooms, living room area, dining area, kitchen, outdoor shaded seating areas, and an attached two car garage. During the visit, LPA Bentley obtained the facility's resident and staff rosters and LIC 500 Personnel Record. LPA toured the interior and exterior of the physical plant with AD Santianez and the following was observed:. All mandated posters were posted near the entrance. There were no bodies of water or obstructions on the premises. 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. Bathrooms were found to be clean and operational. The water temperatures measured at 111.0 degrees F to 113.9 degrees F. A comfortable temperature of 73 degrees F was maintained throughout the facility. CONTINUE TO LIC809-C LPA Bentley observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for cleaning supplies, toxins, and sharps objects were stored and locked. The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available. There is a two car garage with a refrigerator and additional supply of perishable items. The washer and dryer were observed to be in working condition. Facility has a sufficient amount of emergency food supply and water supply. The backyard was clean and free of clutter and debris. A shaded patio area with tables and chairs was observed. Emergency safety drill was last conducted on April 10, 2025 and conducted quarterly. First aid kit is maintained and contains all the necessary elements. Smoke and carbon monoxide alarms were tested and observed operational. A working telephone (949-446-4475) remains available, and the facility has a device that can be used for video teleconference purposes. The facility has three (3) fire extinguisher that were observed charged in the kitchen, laundry room and garage, all last serviced on April 16, 2025. Liability Insurance is effective June 14, 2024 through June 14, 2025. LPA Bentley conducted an audit of six (6) resident files (R1-R6), four (4) staff files (S1-S4), two (2) staff interviews, and five (5) resident interviews. Clients’ medication was found locked and secure and a review of the Medication and Medication Administration Record (MAR) was conducted. Based on today’s observations, two Type B deficiencies were cited during this visit as per Title 22 Division 6 Chapter 8 of the California Code of Regulations. An exit interview was conducted, and a copy of this report, deficiency pages, and appeal rights were provided to Administrator Ray Santianez.