Routine inspection·February 6, 2025

On February 6th, 2025 Licensing Program Analyst (LPA) William Vanegas made an unannounced visit for the purposes of conducting an annual visit. Upon arrival LPA Vanegas was greeted and granted entry by Care Giver (CG) Marjori Facinal and LPA Vanegas explained the nature of the visit. LPA Vanegas set up equipment and began a tour of the facility and observed the following. This is a two storied home with six bedrooms two of which are staff rooms and four of which are resident rooms. There are three bathrooms two of which are resident bathrooms and one of which is a staff bathroom. There is also an attached two car garage. LPA Vanegas observed the kitchen area to be clean and free of mildew and debris. LPA Vanegas observed there to be an electric stove, microwave, refrigerator, and dishwasher all which tested to be operational and in good repair. LPA Vanegas observed a two day supply of perishable food and a seven day supply of non-perishable food. LPA Vanegas observed resident bathrooms to be clean and free of mildew and debris. Water faucet and toilets tested to be operational, and bathrooms contained all required items such as grab bars, slip resistant floor matts, and a shower chair. Water in bathrooms tested to be between 114.3 and 123.2 degrees. LPA Vanegas observed client rooms to have all required furnishings such as a bed, clean linens in good repair meaning no strains or tears, chest drawers, and a reading lamp. However one room did not have a screen on the window a deficiency was cited on today's date. LPA Vanegas observed outside of facility to be clean and have no obstructions along the emergency exit route. Back yard is clean and in good repair, and big enough to participate in outdoor activities upon resident request. There is an outdoor shaded sitting area, and side doors are unlocked and self latching. LPA Vanegas observed all medications, toxins, and sharps to be locked away and inaccessible to clients in care. LPA Vanegas observed fire extinguisher to be fully charged and up to date, and for all carbon monoxide detectors and smoke detectors to be operational and in good repair. CONTINUED ON LIC809C LPA Vanegas reviewed three staff files and six resident files all resident files contained all the required documents and all staff training was undocumented. A deficiency was cited on today's date. LPA Vanegas reviewed first aid kit and it contained all required items such as scissors, adhesive tape, tweezers, first aid manual, and a thermometer. LPA Vanegas reviewed medications and medication administration record (MAR) and per LPA Vanegas review all medications are being administered per physician's orders and they are being documented correctly. Based on today's observations deficiencies will be cited per title 22 chapter six of the California Code of Regulations. An exit interview was conducted and a copy of this report was left at the facility.