Routine inspection·December 31, 2024

On December 31, 2024, at 8:00am, Licensing Program Analyst (LPA) Eboni Bentley conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Bentley was greeted and granted entry by Caregiver (CG) Maria Lorna Flores who called Licensee/Administrator (AD) Emelyn Asis by phone. Licensee Asis informed me that she was out of town and would send Administrator (AD) Rose Asis Ang to facilitate the tour in her place. AD Asis Ang arrived at the facility around 8:45am. AD Asis Ang has a current administrator certificate with an expiration date of August 3, 2026. The facility is licensed to operate for six (6) residents of which two (2) may be non-ambulatory, and a hospice waiver for four (4) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: five (5) resident bedrooms, (1) staff bedroom, two (2) bathrooms, living room area, dining area, kitchen, an outdoor covered seating area, and an attached two car garage. There are currently five (5) residents in care and all were present during today’s visit. Around 9:00am, LPA Bentley toured inside and outside of the physical plant with AD Asis Ang. There were 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, and storage for each resident’s personal belongings was observed. The Resident’s rooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, and Resident Room 4, and one Staff Bedroom. Bathrooms were found to be clean and operational. The water temperature measured between 111.4 degrees F to 119.1 degrees F. A comfortable temperature of 74 degrees F was maintained in the facility. LPA Bentley 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. During the visit, LPA Bentley observed the facility's infection control practices, plan of operation, and fire and disaster plan. The smoke detectors and carbon monoxide detectors were operable. A working telephone (714-630-3212) remains available, and the facility has a device that can be used for video teleconference purposes. Emergency water, and additional supplies were stored in the garage. The facility has one (1) fire extinguisher that was observed charged, mounted in the dining area, and serviced on July 22, 2024. Liability Insurance is effective August 11, 2024 and expires on August 11, 2025. First aid kit is properly maintained and contains all the necessary elements. LPA Bentley conducted an audit of five (5) resident files (R1-R5), four (4) staff files (S1-S4), and medication administration review. LPA Bentley conducted two (2) staff interviews and five (5) resident interviews. Based on observations made during today’s inspection, deficiencies were cited during the time of the visit per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and a copy of this report and appeal rights were provided to Administrator Rose Asis Ang.