Routine inspection·September 30, 2024

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced visit for the Required 1 Year Inspection. LPA explained the purpose of today’s visit, and was greeted and granted entry by Caregiver Tino Soufyan. Administrator (AD) Brian Schott arrived shortly after. For today’s visit, LPA observed a total of six residents in care and two staff members on duty. LPA observed the Administrator's Certificate for Brian Schott which expired on July 23, 2024, however, AD provided proof of payment to show that the certificate is in renewal process. Renewed certificate has not yet been received and is pending. LPA reminded Licensee to post certificate once received. LPA toured the interior and exterior portions of the facility with AD Schott. The facility is a two-story structure and is licensed for one ambulatory resident, five non-ambulatory residents, of which six may be on hospice and zero bedridden. The two-story home consists of five resident bedrooms and four resident bathrooms. There is one staff bedroom and bathroom. The second floor is the living area for the Licensee/AD Schott. LPA toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. Restrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature tested between 111.0-112.8 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to residents in care. Fire extinguisher was charged and located by the kitchen. CONTINUED ON LIC809-C... LPA observed the emergency disaster and evacuation plan which is located by entryway. Facility had back-up emergency food and water supply. LPA observed that First Aid Kit had all the required components. LPA observed that medications and toxins were locked and inaccessible to residents in care. For the exterior portion, LPAs observed a shaded area, patio furniture, and the grounds were free of any hazards. There are two gates in the backyard, which both are self-closing and self-latching. No bodies of water were observed. LPA reviewed six resident and two staff files. LPA interviewed residents and staff present. During today's visit LPA observed a blank pre-admission appraisal in one of six resident files: A Deficiency was issued today. For today's visit deficiencies were issued per Title 22 Division 6 of the California Code of Regulations. LPAs advised AD Schott to use the general email address: CCLASCPOrangeCountyRO@dss.ca.gov for any inquiries and to specify attention to the assigned LPA. An exit interview was conducted with AD Schott. A copy of this report and Appeal Rights were provided at the time of exit.