Routine inspection·February 21, 2025

Licensing Program Analyst (LPA) Nancy Guillen made an unannounced visit for the purpose of conducting a required annual Inspection. LPA was greeted and granted entry by caregiver Agafe Lorzano after explaining the purpose of the visit. Administrator was notified via telephone, but was unable to attend. LPA observed the Administrator certificate expired November 28,2024; a deficiency was cited on today’s date. This is a Residential Care Facility for the Elderly (RCFE) licensed to six non-ambulatory residents with a hospice waiver for five. The facility is a two story home. The first floor is made up of five resident bedrooms, two bathrooms, and an attached garage. The second floor contains 3 rooms and a bathroom that are not for resident use. During the inspection, LPA and caregiver Agafe conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, garage and observed the following: LPA observed residents watching television and resting in their respective bedrooms. LPA observed six residents in care and three staff present. LPA observed the See Something Say Something Poster (PUB 475) mounted on the wall by the entrance. All resident bedrooms had the required furnishings, however toxins were observed in a residents room; a deficiency is being cited on today’s date. LPA observed all resident beds had linens and blankets with additional linens stored in the hallway closet. LPA observed bathrooms were clean and equipped with grab bars and non skid floor mats. LPA observed all windows were appropriately screened. Bathrooms were observed to be free of debris and mildew, faucets and toilets were operational. Water temperature tested between 108.5 and 112 degrees Fahrenheit. LPA toured the outside of the facility and observed outdoor emergency exit was obstructed; a deficiency was cited on today’s date. LPA observed the backyard had a shaded sitting area with furniture for resident use. LIC809C LPA observed the facility had 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 fully charged and operational. Gas stove, microwave, washer, and dryer were all inspected and observed to be operable. Toxic chemicals, cleaning solutions, and disinfectants were observed to be locked in the garage and inaccessible to residents. While touring the garage LPA observed a section of the garage to be used as a bedroom; a deficiency was cited on today’s date. Medication cabinet was observed to be locked and centrally stored in the kitchen area. LPA observed the First Aid Kit had all the required components. LPA began review of the records. LPA Guillen reviewed six resident records. All the required documentation were present and current in the residents’ files reviewed. LPA reviewed three employee records. All employee’s present have a criminal record clearance and were associated to the facility. LPA observed records reviewed have a current First Aid certificate, however no trainings were documented. Per staff interview, no yearly training have been conducted; a deficiency was cited on today’s date. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report and appeal rights was left at the facility.