Routine inspection·September 19, 2024

Licensing Program Analysts (LPAs) Kevin Saborit-Guasch and William Vanegas made an unannounced visit for the purpose of conducting a Required/Annual Inspection. LPA was greeted and granted entry by Individual Benidict Estrella. LPA met with Administrator (AD) Cherryl Sansano and explained the purpose of the inspection. LPA reviewed list of Guardian roster for facility and all staff members present were listed and background cleared. During the inspection, LPA and AD conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, garage and observed the following: This is a two-story home with the upstairs area only used by live in staff and is inaccessible to residents. The home has four resident bedrooms, two shared and two private with two staff bedrooms located on the second level. The home has two bathrooms, one shared and one within a shared room. The home has an attached two-car garage. All resident bedrooms had the required furnishings. LPA observed all resident beds had linens and blankets. LPA observed all windows were screened. The backyard has a shaded sitting area. LPA 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 at 115.0 degrees Fahrenheit. LPA 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 up-to-date maintenance. Gas stove, microwave, washer, and dryer appear to be operable. Toxic chemicals, cleaning solutions, and disinfectants were observed to be inaccessible to residents in the bathroom and laundry room. Medication cabinet was observed to be locked; however, medication is being pre-poured into a plastic weekly medication organizer and in cups for each resident; a Deficiency was cited on this date on the attached form LIC809-D CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 LPAs reviewed five resident files and three staff files. One out of the three staff files was observed not consisting of required staff documents such as TB test, Personnel record, CPR training, and 20 hours of required training. LPAs provided a Technical Advisory Note for the staff record not being present in the facility at the time of the visit. AD advised that she has the staff members files, but at another facility. Three of three resident files were complete and consisted of all required documentation for residents residing in the facility. LPAs interviewed one resident and one staff member. Based on the observations made during today’s inspection, two type B deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations as well as two Technical Violation and three Technical Advisory Notes. An exit interview was conducted, and a copy of this report and appeal rights was left at the facility.