Routine inspection·December 3, 2024

This unannounced inspection is being conducted by Licensing Program Analysts (LPAs) Sean Haddad and Eboni Bentley for the purpose of conducting a Required – 1 Year Inspection. LPAs met with Administrator (AD) Ahmad Ali and discussed the purpose of the inspection. LPAs reviewed Infection Control requirements. At about 1:00PM, LPAs and AD conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, and garage and observed the following: Structure: facility is a 7-bedroom, 4-bathroom, one-story house with an attached garage that is used for storage. There is a back yard with a patio cover for the residents. LPAs and AD observed 1 staff and 2 residents present at the facility. Resident Bedrooms: the 5 resident bedrooms are spacious and will easily accommodate the residents’ furnishings. Furniture for each resident bedroom inspected. Staff Bedrooms: LPAs inspected the two staff bedrooms. Bathrooms: the bathrooms were clean, faucets and toilets were operational. Water temperature: tested 113 degrees and 120 degrees F in the three resident bathrooms. Linens & Hygiene Supplies: new linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu: reviewed. Food Service: LPAs observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food is available as required by regulations. Carbon Monoxide, Smoke Detectors, Fire Extinguisher: observed and tested. Appliances: stove burners, microwave, washer, and dryer inspected. Knives: observed locked in the kitchen. Toxins: observed locked in the garage and shed, after correction. Medication cabinet: observed to be locked. First-Aid Kit and Activity Supplies: observed and available. Facility’s licensing fees are paid. At about 2:30PM, LPAs reviewed 2 resident files and 2 staff files, interviewed 2 residents and 2 staff, and inspected medications for 2 residents. Facility does not handle resident money. CONTINUED During the inspection, LPAs and AD observed the following: based on observations, the licensee's 2 fire extinguishers have not been inspected in the last year; based on observation, the licensee did not ensure laundry detergent and bleach were inaccessible in the non-lockable garage and paints and tools were inaccessible in the non-lockable side shed; based on documents, the licensee has not conducted an emergency disaster drill since March 2024. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809D. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.