Routine inspection·May 16, 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 1:00 PM, LPA Tea was greeted and granted entry into the facility by a caregiver staff and explained the reason for the visit. Administrator (AD) Latoya Johnson arrived shortly to assist with the visit. The facility is licensed for a capacity of six, one maybe non-ambulatory, and five maybe bedridden with a hospice waiver for six. Currently there are six residents, and there is one on hospice during today's visit. At 1:19 PM, LPA Tea reviewed six resident files and three staff files. Resident files and staff files contained all required documentation. The administrator certificate expires on December 21, 2026. LPA Tea along with care staff toured the facility at 2:13 PM. LPA toured the physical plant, checked food service, and the first aid kit. The home consists of 6 resident bedrooms, 5 full bathrooms, medication staff room, living room, kitchen, dining area, 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 111.7 Fahrenheit degrees and 113.3 Fahrenheit degrees. 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 dressing, 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 in a kitchen cabinet. LPA also observed toxin substances to be secured and locked and inaccessible to clients underneath the kitchen sink and garage. The fire extinguishers throughout Annual Inspection continued LIC809C the facility are fully charged. The facility’s last fire drill was conducted on February 18, 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. They also have a barbecue grill for grilling. The exit gate on the right side of the house is self-latching and operational. Facility provides activities based on resident’s personal preference and health condition and limitations. The residents love to play Jengga, do arts and crafts, play puzzles, some go out for walks and do exercise. There is someone that comes to the facility to conduct activities from time to time. Some residents like to tend to the garden in the backyard. At the time of the visit, LPA observed residents watching TV, going out for walks and sitting outside enjoying the nice weather. At 2:46 PM LPA reviewed medication storage and administration. Medications are stored in a locked cart in the medication staff room. Medications are being administered per physician order. LPA interview 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 Administrator Latoya Johnson and a copy of this report LIC809, 809-C, LIC858, LIC859, was read and provided to the facility.