Routine inspection·February 4, 2025

On February 4, 2025, Licensing Program Analyst (LPA) Eboni Bentley arrived at the facility unannounced, for the purpose of conducting a required one-year annual visit using the CARE Inspection Tool. LPA Bentley was greeted and granted entry by Caregiver (CG) Roel Atanacio, and explained the reason for the visit. Administrator (AD) Julie Way Conejo arrived a short time later and was present for today’s visit. AD Cornejo has an Administrator Certificate with an expiration date of June 3, 2026. This facility is a one-story building in a residential neighborhood, licensed to provide services to age range 60 and over, approved for six (6) Non-Ambulatory residents of which one (1) may be bedridden and has a hospice waiver for four (4) residents. Currently, there are five (5) residents on census of which two (2) are receiving hospice care. All five (5) residents were present during today’s visit. Around 9:00AM, LPA Bentley conducted a tour of the physical plant accompanied by AD Cornejo and the following was observed: All resident bedrooms and bathrooms were inspected. Each bedroom had adequate lighting, furniture, bedding, and storage for the residents’ personal belongings. Additional bed linens, comforters, and bath towels were available during the visit. Hot water temperatures in bathrooms were measured and observed between 105.2 degrees and 113.3 degrees Fahrenheit. The kitchen was clean and organized. All knives and sharp objects were kept locked in a drawer below the counter. A supply of perishable food items was observed in the refrigerator and nonperishable food items observed in the cabinets. The garage was partially used for storage and all walkways free of clutter. There was a refrigerator with a supply of perishable items inside. LPA Bentley also observed a washer and dryer, additional boxes of supplies, and emergency food and water. CONTINUE TO 809-C PAGE.... The backyard was clean and free of clutter and debris. There is one (1) side exit gate, clear and accessible and a shaded patio area with tables and seating observed. There are no bodies of water. A review of five (5) residents (R1-R5) service files and four (4) staff (S1-S4) personnel files was conducted. Three (3) residents and two (2) staff interviews were reviewed. A review of the Medication Records Administration (MAR) and medication was conducted, and records were found to be in compliance. The facility has liability insurance effective July 20, 2024 through July 20, 2025. A first aid kit was observed with all the required elements present. There are two (2) fully charged fire extinguishers, observed mounted with a last service date of March 19, 2024. Smoke detectors were tested and operational and the last fire and disaster drill was conducted on January 6, 2025. Three (3) deficiencies and two (2) Technical Violations were cited during today’s inspection visit. An exit interview conducted and a copy of the report was provided to Administrator Julie Way Cornejo.