Routine inspection·March 27, 2025

Licensing Program Analyst (LPA) Raquel Hernandez made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Caregiver Nenita Gorospe and was granted entry to the facility. The facility is a (5) bedroom (2) bathroom home and, with a kitchen/dining area, living room, attach garage. LPA was accompanied by Caregiver to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected client bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed Resident #4 (R4) to have a full bed rail and not currently on hospice care services or doctor ordered. Deficiency will be issued. LPA observed water temperature to test at 120 degrees Fahrenheit. LPA observed sufficient furniture and lighting throughout the facility. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. LPA observed toilet bowl bleach cleaner located underneath Resident #1 (R1) and Resident #2 (R2) bathroom sink unlocked accessible to residents in care. Deficiency will be issued. There was a designated office for client/staff files. Overall, the facility is clean, in good repair, and operating in safe conditions for clients in care. Food Service: Non-perishable and perishable food supply is sufficient for number of clients in care. Facility has a variety of food available for clients. Dishes, cups, and utensils were also stored properly. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. Record Review: LPA reviewed (4) resident files for admission agreements, updated physician reports, and needs and services plans. LPA observed incomplete Appraisal/Needs and Services Plan for Resident #3 (R3) and Resident #4 (R4). Deficiency will be issued. Additionally, LPA observed no Reappraisal forms for Resident #1 (R1), Resident #2 (R2), Resident #3 (R3), and Resident #4 (R4). Deficiency will be issued. LPA reviewed (4) resident medications. LPA Hernandez observed for Resident #2 (R2), Resident #4 (R4) and Resident #5 (R5) no documentation for daily medications in Medication Administration Record (MAR). Deficiency will be issued. Additionally for R2, R4 and R5 PRN medication was not documented correctly. Deficiency will be issued. LPA also reviewed (2) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings. No issues observed. Based on the observations made during today’s visit, deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809), (LIC809-D) was discussed and provided to Administrator Rea Badillo Alim. Along with copy of appeal rights.