Routine inspection·October 2, 2024

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. At around 1:10 PM, LPA Tea was greeted and granted entry into the facility by Administrator (AD) Shellee Smith and explained the reason for the visit. Facility is licensed for six ambulatory residents, of which 6 may be non-ambulatory, with an approved hospice waiver for two. Currently there are no clients in care during today's visit. The administrator hopes to have residents for the facility by the end of the year. LPA Tea along with the Administrator toured the facility at 2:00 PM. LPA toured the physical plant, checked food service, and the first aid kit. The home consists of 5 resident bedrooms, 2 of them are shared, 2 full bathrooms, living room, dining room, kitchen, staff area, and an attached garage. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms to be 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 between 111.2 F degrees and 111.9 F degrees. 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. Kitchen appliances are operational during today's visit. Sharps are locked and stored in a secured cabinet in the staff area along with medication. LPA also observed toxin substances inaccessible to clients in care, locked and secured in the garage. The fire extinguisher is fully charged in the staff area. LPA toured the outside grounds and there is ample seating with shade. There is one exit gate that is self-latching and operational on the left side of the house. The backyard has a pool that is gated. Living room has DVDs, books and an old piano that plays music for potential residents, along with an old stereo sound system and a jukebox in the living room for entertainment. Continuation of the annual report on LIC809-C Based on the observation made during today’s visit, no deficiencies were noted today in the areas inspected per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with Administrator, Shellee Smith and a copy of this report LIC809, 809-C was read and provided to the facility.