Routine inspection·April 28, 2022

Licensing Program Analyst (LPA)Andrea Mendivil conducted an unannounced visit for the purpose of conducting a required/ annual visit. LPA was greeted and granted entry into the facility by Caregiver Charlie Bernardo and Mary Joy Bernardo and explained the reason for the visit. At 2:02pm Administrator Moneli Sharifan arrived. At 1:06 PM, LPA toured the facility with Caregiver Mary Joy . Facility is 5 bedroom, 2 bathroom single story home with a detached garage, Facility has 6 residents present during today's visit. LPA observed residents relaxing in the facility. Facility appears clean and sanitary. All residents rooms had the required elements as well as restrooms stocked with soap/ sanitizer. LPA observed the screening/ sanitizing station in the entrance of the facility. Facility uses a handwritten sign in/ questionnaire. Facility takes residents and staff temperatures daily and documents. The facility mitigation plan has been completed and approved. LPA observed emergency food and water. LPA observed locked medication cabinet. LPA toured the outside grounds and observed outside shaded visitation area. Exit gate is unlocked and self latching. Facility has a plan for covid testing residents and staff as needed as well as a plan for isolation. LPA observed a 4 weeks supply of PPE. LPA reviewed all residents files and all contained required documentation including updated emergency information. At 1:25pm during tour LPA observed the detached garage, when questioned caregiver Mary Joy stated garage was locked. Caregiver called administrator and placed administrator on speaker, LPA Mendivil was told there was no access to garage. LPA Mendivil was able to see into garage and observed a bed, trash can and alarm clock. LPA Mendivil advised caregiver to call administrator as access is needed. Caregiver called administrator and administrator was placed on speaker, LPA Mendivil advised that the garage had bedroom items and LPA Mendivil was told by administrator it was a break room. LPA Mendivil was granted access by caregiver Mary Joy. LPA observed a bed, clothing, medications, and a fridge. Caregiver Mary Joy knocked on a door in another part of the garage and caregiver Christopher Esma answered the door and stated was sleeping. LPA observed 2 beds in the other part of the garage. LPA Mendivil advised Administrator to have keys present at facility during all shifts. Based on the observations made during today's visit, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed and a copy of 809, 809-D ,LIC 421IM and appeal rights were provided.