Routine inspection·April 15, 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 8:48 AM, LPA Tea was greeted and granted entry into the facility by caregiver staff and explained the reason for the visit. Administrators (AD) Ryan Roche and Scott Messick arrived shortly to assist with the visit. Facility is licensed for 6 non-ambulatory residents, with a hospice waiver for six. Currently there are six residents, and two are on hospice during today's visit. LPA Tea along with AD Messick and Roche toured the facility. LPA toured the physical plant, checked food service, and the first aid kit. The home consists of 4 resident bedrooms, which two are shared, 1 staff room, 2 full bathrooms, family and living room, dining room, kitchen, laundry room and attached garage. 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 116.2 F degrees and 114.8 F degrees. LPA did notice a small crack in the sink basin in one of the bathrooms. The crack currently does not pose any threat to resident’s health and safety or hindrance for usage. Administrators will fix the crack and discuss with the property owner about the crack. 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 dressings, 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 underneath the kitchen sink. LPA also observed toxin substances to be secured and locked and inaccessible to clients underneath the kitchen sink and garage. The fire extinguisher Annual inspection continued on LIC809C in the kitchen is fully charged. The facility’s last fire drill was conducted on March 10, 2025. Kitchen appliances are operational during today's visit. LPA observed emergency food and water supply in the garage. LPA toured the outside grounds and there is ample seating with shade and there is a gate on the left side of the house that is self-latching and operational. The backyard has a small garden area. There is a barbecue grill. Also, there is a pool that is secured with a fence that is drained monthly because it is not used by the facility. Facility provides activities daily conducted by an activity’s coordinator. The residents play bingo and trivia, do arts and crafts. The residents go outside from time to time when the weather permits. At the time of the visit, LPA observed residents working on puzzles and playing a round of bingo with the activity’s coordinator. LPA Tea reviewed six resident files and two staff files. Residents’ files and staff files contained all required documentation. The administrator certificates expire on December 1, 2025. LPA reviewed medication storage and administration. Medications are stored in a locked closet by the front entryway. Medications are being administered per physician order. LPA interviewed residents regarding their quality of care and 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, Scott Messick and Ryan Roche and a copy of this report LIC809, 809-C, LIC858, LIC859, LIC9102 was read and provided to the facility.