Routine inspection·August 6, 2024

Licensing Program Analyst (LPA) Lydia Martinez made an unannounced visit on this day for the purpose of conducting a Required - 1 Year inspection. LPA met with Caregivers Mary Grace Dominguez and Jhonny Ang. Administrator Lisa Roche arrived shortly after. Facility is a one story house with 6 private bedrooms, 3 bathrooms, an attached garage, a living room, a dining room, and kitchen. Facility is using existing garage storage room as a staff bedroom. There is a large back yard with 1 exit way on each side of the house, plus a gate that opens into the back street and a community park. There is a covered patio with seating for the residents and visitors. LPA observed and spoke to 4 of 4 residents. No resident is receiving Hospice care. LPA observed the facility to be clean and in good repair. LPA observed hallways and walkways are free of obstruction. The home is maintained at a comfortable temperature. Lighting is sufficient for safety and comfort. Bedrooms were observed to be spacious and easily accommodate furnishings such as lamps, chair, dresser and a bed. Bathroom were observed to be clean, have a supply of soap and paper towels. Hot water temperature was within regulatory requirements. Linen and hygiene supplies were stocked. Emergency Phone Numbers and Exit Plan were reviewed. Food prep area is clean and organized. Food supply meets the requirement of one (1) week supply of non-perishable and two (2) day supply of perishables. Smoke detectors and carbon monoxide detectors were found to be operational. Fire Extinguishers were charged and mounted. Stove burners, dishwasher, microwave, washer, and dryer are operational. Chemicals and sharps are made inaccessible to the residents. Laundry is done in the garage. Medications are centrally stored in a locked kitchen cabinet. Medications reviewed appear to have been dispensed accurately. LPA Martinez interviewed 2 of 2 staff and reviewed resident and staff files. LPA observed the following but not limited to: admission agreements, physician reports, consent forms and personal rights. LPA review staff files and observed the following but not limited to: criminal record clearance, criminal record statement, First Aid, and TB test. LPA noted Administrator's certificate expired on 7/15/2024 and is awaiting current one from Sacramento. Based on the observations made during today’s visit, one deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with Administrator and a copy of this report was provided at the end of the visit via email.