Routine inspection·July 17, 2024

Licensing Program Analyst (LPA) Mary Rico made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with House Manager Briones Bonifacio and was granted entry to the facility. The facility is a (4) bedroom (2) bathroom home and, with a kitchen/dining area, living room, and attached garage. Licensed capacity is (6) current census is (4). LPA was accompanied by House Manager Briones Bonifacio to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected client bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to clients in care. There was a designated space for client/staff files. Food Service: Non-perishable and perishable food supply is sufficient for number of clients in care. Facility has a variety of food available for clients. Dishes, cups, and utensils were also stored properly. Record Review: LPA reviewed (4) client files for admission agreements, updated physician reports, medications and needs and services plans. 1 out of the 4 clients did not have an updated medical assessment. R1 has dementia and last medical assessment was conducted in 2022. Furthermore, facility did not have R1 Hospice Care Plan maintained at he facility. LPA conducted (3) medication audit. LPA also reviewed (2) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings. Based on the observations made during today’s visit, two (2) Type B deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809)(LIC809D) was discussed and provided to House Manager Briones Bonifacio. Along with a copy of the appeal rights.