Routine inspection·January 3, 2025

On this day, Licensing Program Analysts (LPAs) Kevin Saborit-Guasch and Hanna Gough made an unannounced visit to the facility to conduct the required annual inspection. LPAs were greeted and granted entry by facility caregiving staff after introducing themselves and stating the purpose of the visit. Facility manager Bene Therese Molintas was notified by telephone and arrived later to assist with the visit. There are currently four residents in care, two of which are receiving hospice care. LPAs observed residents relaxing in their respective bedrooms. LPAs accompanied by facility staff toured the physical plant. The facility is a one-story house with an attached garage. The facility has five bedrooms including a shared room along with two bathrooms accessed in the hallway and a third en-suite bath attached to the shared room. Additional staff dwelling are in a n Additional Dwelling Unit in the backyard. Bedrooms appeared clean and sanitary. Full bed rails present in one bedroom and half rails for two other residents, orders and hospice plans of care reviewed. LPAs observed all the resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary. Bathrooms are equipped with grab bars and slip mats. Hot water temperature measured at 120 and 123F during the visit and was adjusted down. LPAs observed the kitchen has a minimum two (2) day perishable and seven (7) day non-perishable food supply. Sharp items are stored in a secure drawer. Fire extinguishers are charged and mounted. LPAs tested the smoke and carbon monoxide detectors which were found to be operational. The centrally stored medication is located in a locked closet in the hallway. The attached garage is inaccessible to residents and is used for storage and laundry. Cleaning supplies are stored securely in the garage. LPAs and facility staff toured the outside of the facility. LPAs observed an shaded outdoor seating areas with furniture for resident use. The perimeter gates on one side of the property is self-latching, but is locked via a padlock. Citation issued. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 LPAs reviewed four resident records which included all necessary components. One admission agreement is for a different licensed location also operated by the licensee. Consultation provided. LPAs reviewed resident medication records and prescription orders for all four residents, no discrepancies observed. LPAs reviewed three staff records which were found to be complete. Training and CPR/First aid training reviewed and up-to-date. All staff are background cleared and associated to the licensed location accurately. Based on the observations made during today’s visit, one type B deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. Four consultations provided on attached Advisory Notes form. An exit interview was conducted and a copy of this report along with appeal rights were provided to a facility representative.