Routine inspection·October 4, 2022

Licensing Program Analysts (LPAs) Andrea Mendivil and Alvaro Ramirez conducted an unannounced visit for the purpose of conducting a required/ annual visit. LPAs were greeted and granted entry into the facility by Caregiver Maria Fe Osumra and explained the reason for the visit. Administrator Charles Pham arrived at 10:08 AM. At 9:11 AM, LPAs toured the facility with Caregiver Maria Fe Osumra. Facility is 4 resident bedrooms, 2 resident bathrooms, and 1 staff bathroom, one story home with an attached garage. Facility has 5 residents present during today's visit. LPAs observed a screening and sanitizing station at entrance of the facility. LPAs observed residents relaxing in their room and living room watching TV. Facility appears clean and sanitary. All resident rooms had required elements, including bed, chair, closet space and ample lighting. Restrooms are stocked with soap and paper towels and have hand washing postings. LPAs observed unlocked chemicals under kitchen and restrooms sinks. Facility has 2 refrigerators with ample food supply. At 9:20 AM LPAs observed facility has 72-Hour emergency food and water supply. Facility has a secured location for resident medication and files. LPAs toured the outside grounds and observed outside visitation area. Exit gates are unlocked and self latching. Facility has a plan for covid testing residents and staff as needed as well as a plan for isolation. LPAs observed a 4 weeks supply of PPE. LPAs reviewed all residents’ files and all contained required documentation including updated emergency information. Based on the observations made during today’s visit, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with the facility representative and a copy was provided as well as appeal rights.