Routine inspection·January 30, 2025

Licensing Program Analyst (LPA) Mary Rico made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Licensee/Administrator - Cynthia Garcia and was granted entry to the facility. Licensed capacity is (6) current census (5). LPA was accompanied by Licensee/Administrator Cynthia Garcia 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). LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. 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. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated space for resident/staff files. During facility tour, LPA observed furniture on patio side, blocking facility pathway. In addition the facility had converted the garage storage into a staff bedroom without building permits. Facility's fire clearance indicated the garage should remain for storage purposes. The facility has residents personal belongs unorganized inside the garage. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Facility has a variety of food available for residents. 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 (5) resident files for admission agreements, updated physician reports, and needs and services plans. LPA reviewed (5) resident medications and (2) hospice files. LPA also reviewed (2) staff files for First Aid/CPR certification, criminal record clearance, training's, and health screenings. During medication audit, LPA observed the facility has not been documenting resident's PRN, which include date/time and resident response. In addition, the administrator stated S1 had been working without a criminal record clearance. 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, LIC809D LIC421BG) was discussed and provided to Licensee/Administrator Cynthia Garcia. Along with Appeal Rights.