Routine inspection·July 22, 2024

On 7/22/2024, Licensing Program Analyst (LPA) Janette Romero conducted an unannounced visit to the facility for a required annual inspection. LPA was greeted and granted entry by Caregiver, Jan Daniel Massie who was informed of the purpose of the visit. Administrator, Gerald Dia was present and was also informed of LPA's visit. The facility has a fire clearance for six (6) non-ambulatory elderly residents and an approved hospice waiver for six (6). LPA toured the facility with Administrator Dia and observed the facility is made up of a one-story home with four (4) resident bedrooms, two (2) bathrooms, a staff room, kitchen and dining room. During the tour, Administrator Dia tested one (1) of the smoke alarm/carbon monoxide detectors and LPA observed it to be operational. LPA also observed a charged fire extinguisher mounted in the kitchen. Indoor and outdoor passageways were free of obstruction. The facility has outdoor shaded seating for the residents in care. There were no bodies of water observed on the premises. Medications are secured in a locked kitchen cabinet. Resident bedrooms had the required furniture and lighting. The hot water temperature in the resident bathrooms measured at 105- and 109- degrees Fahrenheit. The facility had a 2-day supply of perishable foods and 7-day supply of non-perishable food items. Staff present have a criminal record clearance and valid first aid/CPR certification. During the visit, LPA requested to review resident files and Administrator Dia reported some files were incomplete. Upon review, LPA observed the files for Resident 1, Resident 2, and Resident 3 only contained signed admission agreements and there were no records for Resident 4. Resident 5 and Resident 6 had complete records on file. During the facility's file review, LPA noted the facility is not current with their annual fees. As a result the facility will be cited pursuant to California Code of Regulations, Title 22. An exit interview was conducted where this report was reviewed and provided to Administrator Dia along with LIC9099-D, Confidential Names List (LIC811), and Appeal Rights.