Routine inspection·March 11, 2025

Licensing Program Analyst (LPA), Armando Perez made an unannounced visit to the facility for the purpose of conducting a required annual inspection. The LPA was granted entry by staff to conduct the inspection and met with caregiver, Fermin Carnista. LPA was informed that Fermin is authorized to assist and provide the required documents for todays visit. The inspection included the following: The facility consists of two buildings. Building 8536 and Building 8548. Both building have a layout consisting of four (4) resident bedrooms, one (1) staff room, two (2) bathrooms, a kitchen and dinning area, a living room area, a garage and laundry room, a covered patio and yard with sufficient seating and space for activities. There are no bodies of water located on the property. According to staff, no weapons are stored in the home. All outdoor and indoor passageways are kept free of obstruction and are free of debris and other trash. There are grab bars for each toilet, bathtub and shower used by residents. Resident showers have non-skid mats present. LPA observed the flooring to be sticky in the hallway and living room of building 8536. A technical assistance will be documented. LPA began review of client records. seven (7) records were reviewed. LPA reviewed for identification and emergency information, admission agreement, medical assessment, and TB test results, needs and service plans, placement, functional assessment, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. LPA observed client records to be incomplete, a deficiency was cited. LPA began review of personnel records- three (3) records were reviewed. LPA reviewed employee records for first aid certification, criminal record clearance or an exemption, health screening and TB test results, employee rights, training verification, and current administrator certification; expiration date 10/01/2026. LPA observed personnel records to be incomplete and a deficiency was cited. LPA observed facility kitchen had the ability to prepare food in clean environment and possessed equipment in good working condition. Food supply meets the requirement of one (1) week supply of nonperishable and two (2) day supply of perishables. Emergency food and water supply is present. There is a locked location for chemicals and sharps in the kitchen. LPA observed two knives stored in an unlocked cabinet in the kitchen and chemicals stored under a bathroom sink. Staff immediately secured items to the correct location, a deficiency was cited. Medications are centrally stored. There is a locked closet allocated for medication storage. Centrally stored medication and destruction logs are maintained. Medications records reviewed was incomplete, a deficiency was cited. LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. Smoke detectors and carbon monoxide detectors were tested. Carbon Monoxide detector was missing in one building and inoperable in the other building. A deficiency was cited. Fire extinguishers was serviced on 10/25/2024. Fire drills are conducted quarterly at the facility with the last drill on 01/16/2025 . Based on the information received during this visit today in the areas reviewed, there are deficiencies that are being cited per Title 22, Division 6 of The California Code of Regulations. Corrections will need to be submitted to be cleared This LIC 809 report was reviewed with the facility representative and a copy was provided.