Routine inspection·April 11, 2025

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry by facility caregiving staff after introducing himself and stating the purpose of the visit. Administrator staff Kimberly Arnett, Michelle Nesbitt and Jozef Springer were notified via telephone and arrived later to assist with the visit. There are currently six residents in care, one of which is receiving hospice care. LPA observed residents relaxing in the facility's common living areas or in their respective bedrooms. LPA accompanied by facility staff toured the physical plant. The facility is a one-story house with a detached garage. The facility has four private rooms, one shared room along with one locked staff room. There is one shared bathroom as well as two and a half en-suite bathrooms throughout the facility. Bedrooms appear clean and sanitary. Four residents are currently using half-rails for postural support along with an additional resident using full rails. Appropriate physician orders and/or hospice plan of care on file for all five relevant residents. All resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary. Hot water temperature measured at 130F in three separate bathrooms with faucets used for personal grooming. Type B deficiency issued and cleared later during the visit. LPA observed the kitchen has a minimum two (2) day perishable and seven (7) day non-perishable food supply. Sharp items, cleaning products and the medication central storage all verified to be secured. Fire extinguishers are charged and mounted, with up-to-date maintenance documented on the attached tags. LPA tested the smoke and carbon monoxide detectors which were found to be operational. The detached garage is inaccessible to residents and used for laundry as well as additional storage of food and supplies. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 LPA and facility staff toured the outside of the facility. LPA observed an shaded outdoor seating area with furniture for resident use. There are self-latching gates on each side of the property and the route of egress is free of clutter and obstructions. There are no bodies of water on the premises. Facility does not utilize locked perimeters or delayed egress. LPA reviewed six resident records which included all necessary components. LPA reviewed resident medication records and prescription orders for all residents with no discrepancies observed. Oxygen is currently in use with adequate signs on display. There are no bedridden residents present on the premises. LPA reviewed staff records for all three caregivers present. Records were found to be complete. Training and CPR/First aid training reviewed and up-to-date. All staff are background cleared and associated to the licensed location accurately. Disaster drills are conducted quarterly. Based on the observations made during today’s visit, one type B deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report along with appeal rights was provided to a facility representative.