Routine inspection·April 30, 2024

On April 30, 2024, at 2:05pm, Licensing Program Analysts (LPAs) Jessica Cho and Edward Kim conducted an unannounced Required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPAs Cho and Kim met with Licensees/Administrators (Admins) Scott Messick and Ryan Roche and explained the purpose of the visit. The facility is licensed to operate for six (6) non-ambulatory and maintains six (6) hospice waivers. The facility is a single-story structure located in a residential neighborhood which consists of the following: five (5) resident bedrooms, two (2) bathrooms, living area, dining area, kitchen, two-car garage, outdoor patio area, and a laundry room which is being currently renovated into a bedroom. Per review of records, facility does not have an approved fire clearance for the renovated room, however facility maintains a building permit which was provided to LPAs during the visit. LPAs toured inside and outside of the physical plant. There are no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each client’s personal belongings were observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. . All bedrooms were inspected for: Resident Rooms #1-5. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured at 115.5 and 113.5 degrees Fahrenheit. A comfortable indoor temperature of 77 degrees Fahrenheit was maintained in the facility. LPAs observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharp objects were stored and inaccessible to the residents. The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly. The facility has two fire extinguishers that are charged and serviced on 11/01/2023. Smoke/carbon monoxide detectors were tested and operable. The facility conducted a Fire/Safety Drill on 01/14/2024. A working telephone (949-859-8391) remains available. First Aid Kit contained all the necessary elements. During the visit, LPAs observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. The 'See Something Say Something" (PUB475) was maintained at 16"x26" which did not meet the required measurements of 20"x26." LPAs conducted an audit of six residents' service files, and two staff personnel files which were in order and completed. LPAs conducted two staff interviews. No resident interviews were conducted due to residents being occupied with their afternoon activities. Medications were audited for six residents and no discrepancies noted for six out of the six residents. Based on the observations made by the LPAs, one deficiency is being cited today as per the Title 22, Division 6, Chapter 8 of the California Code of Regulations. An Advisory Note is being issued, and an immediate civil penalty is being assessed. See LIC421IM. An exit interview was conducted with Licensees/Administrators Ryan Roche & Scott Messick, and a copy of this report along with the LIC809C, LIC809D, LIC421IM, and the appeal rights were provided at the end of the visit.