Routine inspection·December 4, 2024

Licensing Program Analysts (LPAs) Michael Tea and Fred Arias conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. LPAs Tea and Arias were greeted and granted entry into the facility by caregiver, Nicanor Del Rosario and explained the reason for the visit. Administrator (AD) Nida Granville arrived shortly to assist with the visit. Facility is licensed for six non-ambulatory residents, of which one may be bedridden with a hospice waiver for four. Currently there are six residents, of which two are on hospice during today's visit. LPAs Tea and Arias reviewed six resident files and two staff files. There were discrepancies noted in the review of resident and staff files. Administrator certificate expires on December 12, 2025. LPAs Tea and Arias along with the Administrator toured the facility at 2:18 PM. LPAs toured the physical plant, checked food service, and the first aid kit. The home consists of 4 resident bedrooms, 1 staff bedroom, 3 bathrooms, living room, dining room, kitchen and attached garage. LPAs observed smoke detectors/carbon monoxide in common areas and bedrooms and are operational. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured around 123 degrees F. LPAs explain that water temperature needs to be between 105 F to 120 F degrees, anything higher needs warning signs to be posted. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards, doorways were free of obstructions. First aid kit had all the required elements including bandages, tweezers, thermometer, and scissors. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. LPAs observed sharps locked in a kitchen drawer. LPAs also observed toxin substances to be locked and inaccessible to clients in care underneath the kitchen sink. The fire extinguishers throughout the facilities were fully charged. Kitchen appliances are operational during today's visit. Continuation of annual inspection on LIC809-C LPAs toured the outside grounds and there is ample seating with shade and the two exit gates on both sides of the facilities are self-latching and operational. LPAs observed emergency food, water and supplies in the garage. Facility provides activities based on resident interests, in the form of fun activities such as games, like bingo and coloring and helping with gardening outside. At the time of the visit, LPAs observed the residents watching television and coloring. LPAs reviewed medication storage and administration. Medications are stored in a locked cabinet in the kitchen. Some of the residents medications were not properly secured and documented properly. Licensee and staff placed the rest of the medications securely in the garage where residents do not have access to. LPAs interviewed residents regarding their quality of care. The following deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with Administrator Nida Granville and a copy of these reports were given to the facility along with a copy of the LIC 858; 859;809-D, 9102 and Appeal Rights.