Routine inspection·February 15, 2024

Licensing Program Analyst (LPA) Jessica Cho arrived unannounced for the purpose to conduct the Required 1-Year Annual Inspection. LPA was greeted and granted entry after stating the purpose of the visit to Caregiver Maryrose Sagum. Administrator (Admin) Mark Cruz and Office Manager Justin Cruz arrived shortly after to assist with the inspection. LPA conducted a tour of the physical plant accompanied by Caregiver Sagum and Admin Cruz. The following were observed: This is a single story facility comprised of four resident bedrooms and three resident bathrooms, laundry room/2-car garage, living/family room, and dining room. LPA toured the outside grounds. There was shading and sufficient seating for the residents. The exit gate was self-closing and self-latching. LPA observed four residents and three caregivers on duty. The resident bedrooms are spacious and easily accommodates the residents' furnishings. Furniture for each resident bedrooms were inspected. The bathrooms were clean, faucets, toilets, and grab bars were operational. The hot water temperature measured at 118.5, 118.2, and 116.6 degrees Fahrenheit. There were sufficient supply of clean linens. LPA observed a two-day supply of perishables and a seven-day supply of non-perishable food as required per regulation. Carbon monoxide, smoke detectors, and the auditory devices were tested and operational. The fire extinguisher was serviced on 03/21/23. Medications, sharps, and toxins were locked and inaccessible to the residents. Facility had ample supply of emergency supplies including food/water and first aid kit. LPA reviewed four out of the four resident files and two out of the two staff files including resident medications. Administrator was reminded on the following items: to conduct quarterly emergency drills of different variations, to accurately document when the medication was refused on the Medication Administration Record (MAR), and to dispense the medications matching the corresponding calendar date. Based on the observations made during today's visit, no deficiency is being cited as per the Title 22 Division 6 Chapter 2 of the California Code of Regulations. Advisory Notes (LIC9102s) are being issued during the visit. An exit interview was conducted with Administrator Mark Cruz and Office Manager Justin Cruz, and a copy of this report including the LIC809C, and the LIC9102s were provided at the end of this visit.