Routine inspection·June 17, 2023

Licensing Program Analyst (LPA) Janette Romero conducted an unannounced annual required visit to the facility at 9:30 a.m. LPA met with Administrator Paolo Angeles who was informed of the purpose of the visit. During the visit, there were five (5) residents, and three (3) staff present. The facility is made up of a one-story home with five (5) resident bedrooms, two (2) bathrooms, family room, dining area, kitchen, and an attached garage. LPA conducted a tour of the interior and exterior, and reviewed facility documents. LPA observed the following: Bedrooms : Client bedrooms were each furnished with a bed, chair, closet, clothing storage, lighting, and an operable smoke alarm/carbon monoxide detector, in accordance with California, Code of Regulation, Title 22. Bathrooms : Both bathrooms have a working toilet, wash basin, and were equipped with a grab bar and non-slips mats in the shower. LPA tested water temperatures in resident bathrooms and water temperatures were measured at 106- and 107-degrees Fahranheit. The facility has clean towels, blankets, and linen, available in different colors for each client. Kitchen : LPA observed a sufficient supply of dishes, glasses, utensils, pots, and pans. Sample menu is posted on kitchen wall. The stove is operational. Refrigerator and freezer were in working condition. LPA observed sufficient perishable and non-perishable food available for the residents. A fire extinguisher was charged and mounted on the kitchen wall. Laundry : Laundry room was equipped with an operable washer and dryer. Centrally Stored Medications: LPA observed a first aid kit with required components, and locked area for medication storage. Continued on LIC809-C.. Living/Family room : The family room had a working television. Let-Us-No poster, Long- Term Care Ombudsman poster, emergency phone numbers, and facility sketch were posted in the kitchen/family room area. Hallways were free of obstructions. Yard/Outside Ar ea: Covered patio seating is available for the residents. A brick wall secured the entire backyard. All outdoor pathways were free of obstructions. There were no bodies of water observed anywhere on the property. There were no firearms or ammunition observed at the facility, and LPA was informed the facility will not store firearms or ammunition on the premises. There were no deficiencies noted at the time of the visit. An exit interview was conducted, and a copy of this report was reviewed and provided to facility Administrator, Paolo Angeles.