Routine inspection·June 13, 2024

On June 13, 2024 at 1:40pm, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim met with Caregivers Jimmy Infante and Janet Infante, and explained the purpose of the visit. The facility is licensed to operate for six (6) non-ambulatory and have a hospice waiver for six (6) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: five (5) resident bedrooms, one (1) staff bedroom, two (2) bathrooms, living room, dining room, kitchen, an attached garage, and an outside covered patio area. LPA Kim toured indoor and outdoor of the physical plant Caregiver Infante. There are no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. All bedrooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, Resident 4, Resident Room 5, and Staff Room 1. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured at 106.7 degrees F to 109.1 degrees F. A comfortable temperature of 75 degrees F was maintained in the facility. LPA Kim observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly. Emergency supplies, food, and water are in order and complete. The facility has one (1) fire extinguisher that is charged and that was serviced on March 5, 2024, smoke detectors, and carbon monoxide detectors were operable. The facility conducted Fire/Safety Drill March 14, 2024 and is done quarterly. A working telephone (714-833-5911) remains available. Evaluation Report Continues on LIC 809-C During the visit, LPA Kim observed the facility's infection control practices, plan of operation, and screening protocols for visitors, staff, and residents. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. First Aid Kit contained all the necessary elements. LPA Kim conducted an audit of resident files (R1-R5), staff files (S1-S7), and medication and medication administration review. LPA Kim conducted two (2) staff interviews and five (5) resident interviews. A deficiency was cited during this inspection visit according to the California Code of Regulations (Title 22, Division 6, Chapter 8). An exit interview was conducted, and a copy of this report was provided to Caregivers Jimmy Infante and Janet Infante.