Routine inspection·February 4, 2025

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required annual inspection. LPA was greeted and granted entry by staff. LPA explained the reason for the visit. The facility is licensed for 6 residents of which 4 can be non-ambulatory and approved for 1 bedridden and a hospice waiver for 3. 6 residents were present during the visit of which 3 are on hospice. Facility is a single story house with 7 bedrooms (1 bedroom is for staff), 5 bathrooms, kitchen/dining room, living room and a 2 car garage that is being used for storage. LPA observed the See Something, Say Something poster (PUB 475) posted next to the front door. LPA and staff toured the facility. LPA observed all resident bedrooms have the required furnishings. LPA observed extra linens stored in the hall closet. LPA observed all the bathrooms are clean and operational. Hot water measured 115.3 to 115.7 degrees Fahrenheit in all bathrooms. LPA observed in bathroom 4 there were cleaning supplies, 409 spray cleaner, Lysol and toilet bowl cleaner under the bathroom sink which was unlocked. Staff removed the items and put them in a locked cabinet during the visit. Smoke detectors and carbon monoxide detectors tested operational. LPA observed the fireplace in the living room is screened and needs a key to operate, the key is kept locked. LPA did not observe any obstacles or trip hazards in the facility. LPA observed the kitchen is clean and operational. Knives are kept locked in a kitchen drawer. Cleaning supplies are kept locked under the kitchen sink. LPA observed a 2 day perishable and a 7 day non-perishable food supply on hand in the kitchen. The fire extinguisher in the dining room is fully charged. LPA and staff toured the garage. The garage is kept locked and used for storage. LPA observed a 3 day emergency supply of food and water in the garage. LPA and staff toured the backyard. No bodies of water observed. There is shaded seating in the backyard to sit outside. Both exit gates are operational. No obstacles or hazards observed in the backyard. During the visit Administrators, Loida Angeles, Kristina Adrineda arrived. LPA reviewed 2 staff files. Both staff members are background cleared and associated to the facility. Both staff members have the required training and CPR training. LPA reviewed 6 resident files and medications. No discrepancies observed. LPA inspected the first aid kit, the first aid kit has all the required elements. LPA observed there is a laptop for dedicated resident use. There is no verification that facility has conducted an emergency drill in the last 3 months. Deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of the report provided along with appeal rights.