Routine inspection·April 7, 2025

Licensing Program Analyst (LPA) Debbie Palacios made an unannounced visit to the facility to conduct a required annual inspection. LPA met with Caregiver Sunny Rosete who was informed of the purpose of the visit. The facility has a fire clearance for six (6) Non ambulatory residents and serves Ages range 60 and over. Staff present has a criminal record clearance and are associated with the facility. LPA toured the facility and reviewed records. During the tour, LPA observed the facility is made up of a one-story home with six (6) resident bedrooms, one (1) staff bedroom, one (office room) and three (3) bathrooms, two (2) resident bathrooms and one (1) staff bathroom, a living room, dining room, kitchen, and attached garage. All resident bedrooms had the required furniture, lighting, and closet storage. LPA toured the facility's exterior and observed outdoor pathways were free of obstructions. LPA toured the kitchen and observed the facility has a two-day supply and perishable foods and more than a seven-day supply of non-perishable foods that were observed to be properly stored and readily available. Knives and sharp instruments were secured in a locked kitchen cabinet under the sink. LPA toured the garage and observed no additional refrigerators nor resident items . LPA reviewed resident and staff file records. Resident files reviewed had updated Physician's report, Care Plan and Resident Appraisal. Staff files reviewed had the Department's required training records and valid first aid/CPR certification. LPA was unable to review Fire and Earthquake quarterly drills; there was no proof of documents on file (Deficiency Cited) . LPA reviewed the physical medications and Medication Administration Record and did not discover any discrepancies. LPA also observed the facility has a locked cabinet in the hallway filled with additional cleaning solutions, disinfectants, and laundry detergents. LPA also observed additional clean towels, blankets, and linens for the residents stored in the hallway closet. LPA observed three (3) fire extinguishers mounted throughout the facility without serviced tags or receipts as proof of service were not provided (Deficiency Cited). Based on facility missing Fire and Earthquake drill documentation and expired extinguisher's, a deficiency will be cited. An exit interview was conducted. A copy of this report, LIC 809-D, and the appeal rights were provided to caregiver Sunny Rosete.