Routine inspection·January 27, 2025

Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit for the purpose of conducting the required annual inspection. LPA was greeted and granted entry by caregiver staff after explaining the purpose for the visit. Licensee Daryll Avendano, House Manager (HM) Mark Cruz, and Office Manager (OM) Kelsey Choi were notified via telephone and later arrived to assist with the inspection. LPA observed that Administrator Eleonor Avendano has a valid Administrator certificate which expires on October 29, 2025. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents with a hospice waiver for four. The facility is a single story home with four resident bedrooms, two of which are shared and two of which are private, one staff room, two shared resident bathrooms, a living room, a dining room, a kitchen, and an attached two car garage. LPA accompanied by the HM conducted a tour of the physical plant. On today's visit, LPA observed six residents in care and two caregiver staff present. LPA observed residents relaxing in the living room and in the dining room. LPA observed the See Something, Say Something poster (PUB 475) mounted on a wall by the entryway of the facility. LPA inspected the four resident bedrooms, and they were observed to be free of any hazards. LPA observed the resident bedrooms had the required furnishings of a bed, a chair, a chest of drawers, and a lamp. All resident beds had clean linens and blankets. LPA observed additional linens are stored in a hallway closet. LPA inspected the two shared resident bathrooms. Resident bathrooms are clean. Bathrooms are equipped with grab bars and non-skid floor mats. Faucets and toilets were operational. Hot water temperature measured between 114.6 and 114.9 degrees Fahrenheit. LPA observed the staff room is kept locked and inaccessible to residents in care. LPA observed the kitchen has a two day perishable and seven day nonperishable food supply on hand. LPA observed kitchen appliances to be clean and operational. LPA observed kitchen knives are stored in a locked kitchen cabinet. CONTINUED ON LIC809-C A fire extinguisher is located in the hallway by the kitchen, and it was observed the be charged and serviced as of April 5, 2024. LPA tested the wired smoke detectors/carbon monoxide detectors which tested operational. LPA observed the facility conducted their last emergency disaster drill on January 13, 2025. The centrally stored medication is kept in a locked closet by the kitchen. LPA observed the facility has a three day emergency food and water supply stored in the locked closet by the kitchen. LPA observed a First Aid kit to be stored in the dining room. LPA observed the First Aid Kit has all the required components. The door leading to the attached two car garage is kept locked and inaccessible to resident. The garage is used for storage and laundry. LPA observed chemicals to be stored in the locked two car garage. LPA and HM conducted a tour of the exterior portion of the facility. LPA observed the exterior portion to be clear of obstructions and hazards. LPA observed a shaded outdoor seating area with furniture for resident use. The perimeter gate on the southside of the facility is self-latching and can be opened in an evacuation. There are no bodies of water on the premises. LPA reviewed the six resident files. All the required documentation were present and current in the resident files reviewed. LPA reviewed six residents’ medication and medication records. LPA reviewed two staff files. All staff are background cleared and associated to the facility. Based on today's observations, there are no deficiencies being cited per Title 22 of the California Code of Regulations. An exit interview was conducted with Licensee Daryll Avendano, House Manager Mark Cruz, and Office Manager Kelsey Choi, and a copy of the report was provided.