Routine inspection·September 6, 2024

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of conducting the Required Annual Inspection. LPA was greeted and granted entry by facility administrator Maria Lat after introducing himself and stating the reason of the visit. During the inspection, LPA and facility staff conducted a tour of the physical plant and observed the following: The facility is a one-story home with four private bedrooms, two of which have en-suite bathrooms and the other two sharing a Jack-and-Jill bathroom, in addition to the facility's common living areas. Bathrooms are observed to be equipped with grab bars and slip mats. All resident bedrooms have the required furnishings. LPA observed all beds have linens and blankets. There are currently four residents admitted to the facility, none of which are currently receiving hospice care. Bathrooms faucets and toilets are operational. Water temperature was verified to be within acceptable range. LPA observed emergency disaster plan with means of exiting and emergency phone numbers listed and posted. Fire and emergency drills have been conducted quarterly as confirmed by staff interview but not formally documented. LPs provided consultation on the information needed to be maintained on file. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food. Smoke and carbon monoxide detectors tested operational. Fire extinguishers present are observed to be fully charged. There is adequately shaded outside space with outdoor furniture present. There are self-latching gates on both sides of the house and routes of egress are free of obstructions. Medication and sharp items are confirmed to be inaccessible throughout the physical plant. The medication central storage was also observed to be secure. A bleach bottle and health supplements are however observed to be present and not secure during the walk-through. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 LPA reviewed four resident files and three staff files. Resident records include all necessary components. All staff members are confirmed to be cleared and associated with this particular licensed location. Per observation, interview and records reviewed, one resident was confirmed to have been assessed as bedridden and requiring a Hoyer lift to be transferred out of the bed. The current fire clearance for the facility does not include any provision for a bedridden resident. 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. Three Technical Assistance advisory notes are provided as well with a consultation on the emergency and fire drills documentation, sufficient staffing requirements as well as the required Infection Control Plan. An exit interview was conducted, and a copy of this report along with appeal rights was left at the facility.