Routine inspection·March 30, 2023

Licensing Program Analyst (LPA) Lydia Martinez made an unannounced visit to conduct a Required – 1 Year Annual inspection. Upon arrival LPA was greeted and granted entry by Carestaff AnnaMarie and Darwin Gamboa. LPA began inspection with introduction and visit purpose. There are currently 6 Residents residing and present at the facility. Facility currently has 4 Residents receiving Hospice care. Administrator (AD) Liza Mesdjian arrived shortly after. LPA along with Carestaff AnnaMarie conducted a tour of the inside and outside of the facility. LPA observed the facility to be clean and in good repair. The home is maintained at a comfortable temperature for the Residents. Lighting is sufficient for safety and comfort. The facility is a one story, 7 bedroom, 8 bathroom home with a dining room, living room, kitchen, and attached garage. There is a back yard with a patio table and chairs and a canopy for shade. Resident bedrooms were observed to be spacious and easily accommodate furnishings such as lamps, chair, dresser and a bed. Bathrooms were clean, faucets, showers and toilets were operational. Hot water in bathrooms was within regulatory requirements. Linen and hygiene supplies were stocked in hallway closets. Emergency Phone Numbers and Exit Plan were reviewed. Food prep areas are clean and organized. Food supply meets the requirement of one (1) week supply of non-perishable and two (2) day supply of perishables. Emergency food and water supply is available. Smoke and Carbon Monoxide detectors are centrally wired and were found to be operational. Fire Extinguishers were charged and mounted, last serviced on 02/28/2023. Stove burners, microwave, dishwasher, washer, and dryer are operational. There is a locked location for chemicals and sharps in the kitchen. Laundry is done in the laundry room. The garage is used for storage. Medications are centrally stored and locked in a locked kitchen cabinet. LPA reviewed medication for Residents. Medications reviewed appear to have been dispensed accurately. (see LIC809C) First-Aid Kit and Activity Supplies, were observed and available. There is a working land line at the facility. The LIC610, Emergency Disaster Plan is posted. Facility’s licensing fees are fully paid. Indoor passageways are free of obstruction. LPA observed a washer, recliner, old mattress outside in backyard. Exit gate is self latching. LPA reviewed 6 Resident files. Files showed that three of six Physician's Reports indicated a confirmed Dementia diagnosis yet were dated by up to two years prior. LPA reviewed 2 Carestaff files. Facility staff do not have documented required training. Administrator Certificate expires on 07/29/2024. LPA interviewed Residents and Carestaff. Based on the information received during this visit today in the areas reviewed, deficiencies are being cited per Title 22, Division 6 of The California Code of Regulations. Copy of this report will be sent to email on file.