Routine inspection·November 15, 2024

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of conducting the required annual inspection. LPA was greeted and granted entry by facility administrator Constantin Mitrica after introducing himself and stating the purpose of the visit. There are currently six residents in care, five of which are receiving hospice care at the time of the visit. LPA accompanied by facility staff conducted a tour of the physical plant and observed the following: the facility is a one-story home with an attached garage accessible from the side yard and secured with a locking doorknob. The facility has four private and one shared bedrooms along with one shared bathroom and a secure bathroom used by staff. The second bathroom has a digital lock on the knob and is locked with a code. The bathroom in use by residents is observed to be equipped with grab bars and slip mats. All resident bedrooms have the required furnishings and linen present. Bathrooms faucets and toilets are operational. Water temperature was measured at 113.3F in the bathroom used for personal hygiene. LPA observed all beds have linen and blankets. There are full rails used for postural supports on five of the beds. Hospice plan of care reviewed for all five residents on hospice. Hospice staff had initially forgotten to include the bed rails on four of the five plans of care reviewed. Updated plans of care were however obtained during the visit and reviewed by LPA. A consultation of the required documentation for postural supports was provided to the licensee. LPA observed emergency disaster plan with means of exiting and emergency phone numbers listed and posted. Drills are conducted and documented. Three drills are verified to have been conducted in 2024. LPA provided licensee with a consultation on the frequency of drills and licensee confirmed a fourth drill would be conducted before the end of the year. Smoke and carbon monoxide detectors tested operational. The fire extinguisher present is fully charged and has been maintained in 2024. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 There is adequately shaded outside space with outdoor furniture present. There are self-latching gates on each side of the property. The routes of egress are free of obstructions. There are no bodies of water on the premises. The kitchen is clean and equipped with operational appliances. Facility staff was observed cooking the evening meal during the visit. A sufficient supply of perishable and non-perishable food is observed to be stocked in the kitchen refrigerator and freezer, as well as in the pantry and additional refrigerator and freezer in the locked garage. Cleaning products are observed to be secure throughout the physical plant, both under the kitchen sink in a locked cabinet as well as in the locked garage where the laundry area is located. Sharp items are verified to be stored in a drawer secured by a magnetic lock. The medication central storage was also observed to be secure and reviewed to be accurate and up to date with the resident's prescription orders. LPA reviewed six resident files along with five staff files. Resident records include all necessary components. One admission agreement is electronically signed and will be signed physically upon the next visit from the resident's responsible party. Consultation provided. All staff members on the facility's roster are confirmed to be cleared and associated with this particular licensed location. Training and CPR training verified to be up to date. Health screenings are on file for all staff members. One resident interview was conducted during the visit. Based on the observations made during today’s inspection, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. Three Technical Assistance Advisory Notes and consultations are provided to the licensee. An exit interview was conducted and a copy of this report was provided to a facility representative.