Routine inspection·April 15, 2025

On 4/15/25 at 12:35 PM, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility for the purpose of conducting the required annual inspection. LPA was greeted and granted entry into the facility by care giving staff after explaining the purpose for the visit. Compliance Manager/Administrator (AD) Michelle Nesbitt and Executive Administrator (EA) Jozef Springer were notified via telephone and later arrived to assist with the inspection. LPA observed that Compliance Manager/Administrator Michelle Nesbitt has a valid Administrator certificate which expires on April 11, 2026. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents and has a hospice waiver for six. The facility is a single story home with five resident bedrooms, one of which is shared, two staff bedrooms, three resident bathrooms, a living room, a dining room, a kitchen, a laundry room, and an attached two car garage. LPA, accompanied by the AD, conducted a tour of the interior portion of the facility. On today's visit, LPA observed five residents in care and three care giving staff present. LPA observed the See Something, Say Something poster (PUB 475) mounted on the wall by the entryway of the facility. LPA inspected the five resident bedrooms and they were observed to be free of hazards. LPA observed resident bedrooms to have the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPA observed resident beds to have clean linens and blankets. LPA observed additional linens to be stored in a hallway cabinet. LPA inspected the three resident bathrooms and they were observed to be clean. Resident bathrooms are equipped with grab bars and nonskid floor mats. Faucets and toilets were operational. Hot water temperature measured between 107.7 and 118.2 degrees Fahrenheit. LPA observed the two staff bedrooms to be kept locked and inaccessible to residents in care. CONTINUED ON 809-C LPA observed the kitchen has a two day perishable and a seven day nonperishable food supply on hand. LPA observed kitchen appliances to be clean and operational. The four burner gas stove lights unassisted. LPA observed knives and sharps to be stored in a locked kitchen cabinet. LPA observed chemicals and toxins to be stored in a locked kitchen cabinet under the sink. LPA observed fire extinguishers to be located in the kitchen, in the laundry room, and in the two car garage. LPA observed fire extinguishers to be charged and serviced as of April 8, 2025. LPA tested the dual smoke detectors/carbon monoxide detectors which tested operational. LPA observed the facility conducted their last emergency disaster drill on March 1, 2025. LPA observed the centrally stored medication to be kept in a locked storage cabinet in the kitchen. LPA observed a First Aid Kit mounted on the wall in the kitchen and it had all the required components. LPA observed chemicals and toxins to be stored in a locked cabinet in the laundry room. LPA observed the door leading to the attached two car garage to be kept locked and inaccessible to residents in care. LPA observed the garage to be used for storage. LPA observed the facility has a three day emergency food and water supply to be stored in the garage. LPA, accompanied by the AD, conducted a tour of the exterior portion of the facility which includes a patio and the backyard. LPA observed the exterior to be clear of obstructions and hazards. LPA observed a shaded outdoor seating area with furniture for resident use in both the patio and in the backyard. The perimeter gates on the north side and east-side are self-latching and can be opened in an evacuation. There are no bodies of water on the premises. LPA reviewed all five resident files. All the required documentation were present and current in the resident files reviewed. LPA reviewed all five residents' medication and medication records. LPA reviewed three staff files. All staff are background cleared and associated to the facility. Based on the observations made during today's visit, no deficiencies are being cited per the Title 22 of the California Code of Regulations. An exit interview was conducted with Compliance Manager/Administrator Michelle Nesbitt and Executive Administrator Jozef Springer. A copy of the report was provided.