Routine inspection·February 5, 2025

Licensing Program Analysts (LPAs) Claudia Gutierrez and Hanna Gough made an unannounced visit for the purpose of conducting a Required/Annual Inspection. LPAs were greeted and granted entry by Staff Anthony “Tony” DeGuzman and explained the purpose of the inspection. During the inspection, LPAs and Staff DeGuzman conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, garage and observed the following: This is a one-story home with four resident bedrooms, three staff bedrooms, three bathrooms, and attached two-car garage. All resident bedrooms had the required furnishings. LPAs observed all resident beds had linens and blankets. Resident beds were also observed to have half bed rails, however, a physician order for four of four residents could not be provided; a Deficiency was cited on today’s date. LPAs observed all windows were screened. The backyard has a shaded sitting area. LPAs observed residents watching television in the living room and resting in their respective bedrooms. Bathrooms were observed to be free of debris and mildew, faucets and toilets were operational. Water temperature tested between 117.3-118.0 degrees Fahrenheit. LPAs observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Smoke detectors and carbon monoxide detectors tested operational. Fire extinguisher was observed to be fully charged with service tag dated January 9, 2025. Gas stove, microwave, washer, and dryer were all inspected and observed to be operable. Toxic chemicals, cleaning solutions, and disinfectants were observed to be inaccessible to residents. Medication cabinet was observed to be locked. LPAs reviewed four resident files and two staff files. Four of four resident files did not contain an appraisal dated or signed in the last twelve months; a Deficiency was cited on today’s date. One of four resident files was observed to be missing an admission agreement and staff was unable to provide LPAs with a copy; a Deficiency was cited on today’s date. (Cont. LIC 9099-C) Staff files did not contain any documentation for initial medication staff training or staff training conducted in the past year and staff was unable to provide LPAs with a copy of staff training conducted; a Deficiencies were cited on today’s date. LPAs interviewed residents and staff. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report and appeal rights were left at the facility.