Routine inspection·May 19, 2025

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. At around 1:00 PM, LPA Tea was greeted and granted entry into the facility by a caregiver staff and explained the reason for the visit. Administrators (AD) Brenda Truong and Kristine Truong arrived shortly to assist with the visit. The facility is licensed for a capacity of six, approved for one ambulatory and five non-ambulatory, with a hospice waiver for four. Currently there are five residents, and there is no one on hospice during today's visit. At 1:25 PM, LPA Tea reviewed five resident files and two staff files. Resident files and staff files contained all required documentation. The administrator certificate expired on March 21, 2025, but AD Truong completed all course work and is pending. LPA Tea along with administrators toured the facility at 2:37 PM. LPA toured the physical plant, checked food service, and the first aid kit. The home is a two-story facility that consists of 5 resident bedrooms, 2 full bathrooms, living room, kitchen, dining area, and attached garage. The 2nd floor of the house is for staff only. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms are operational. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 107.7 Fahrenheit degrees and 108.8 Fahrenheit degrees. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards, doorways were free of obstructions. First aid kit had all the required elements including dressing, bandages, tweezers, thermometer, and scissors. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. LPA observed sharps secured in a kitchen drawer. LPA also observed Annual Inspection continued LIC809C toxin substances to be secured and locked and inaccessible to clients underneath the kitchen sink and garage. The fire extinguishers throughout the facility are fully charged. The facility’s last fire drill was conducted on January 27, 2025. Kitchen appliances are operational during today's visit. LPA observed emergency food and water supply in the kitchen and garage. LPA toured the outside grounds. The patio furniture is currently being replaced at the time of the visit. The gates on both sides of the house are self-latching and operational. Facility provides activities based on resident’s personal preference and health condition and limitations. There is music therapy, chair exercises. There is group discussion and an activities person comes to the facility from time to time. The facility host luncheons and celebrate holidays together. There are arts and crafts activities. At the time of the visit, LPA observed residents watching TV and enjoying snacks. At 3:00 PM LPA reviewed medication storage and administration. Medications are stored in a locked cabinet in the kitchen. Medications are being administered per physician order. LPA advises facility needs to list PRNs on a separate list. LPA was unable to interview residents regarding their quality of care due to language barriers and health conditions of residents. LPA Tea spoke to staff present regarding care provided. Based on the observation made during today’s visit, no deficiencies were noted today in the areas inspected per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with Administrators Brenda Truong and Kristine Truong and a copy of this report LIC809, 809-C, LIC858, LIC859, LIC9102TVs were read and provided to the facility.