Routine inspection·February 25, 2025

On 02/25/2025, Licensing Program Analyst (LPA) Javina George made an unannounced visit to the facility to conduct a 1 year required visit. LPA met with Caregiver Asuncion Buscaino and informed her of the purpose of the visit. The administrator's were unable to come to the facility as they were out of state. During the visit, there was five (5) residents and two (2) staff present. LPA verified the contact information that the department has on file to be accurate. The facility has an approved fire clearance to for six (6) non-ambulatory residents over the age of 60, an approved hospice waiver for (4) residents. There are currently (2) residents receiving hospice services. Prior to coming to the facility LPA conducted a file review and observed that on 02/24/25 the facility annual licensing fees have not been paid. The fees are due by 03/09/25, LPA provided the following PIN 120899, should the Administrator wish to pay the fees electronically . LPA observed residents to be asleep and (1)to have a visit with hospice. Records review of staff present ha a criminal record clearance and to be associated to the facility in addition to having on file valid first CPR/ first aid certification. LPA conducted a records review from the Administrators Certification Bureau and observed under active certificates list as well as pending renewals application for nothing to be found for both Richard and Jennifer Friend. Both Richard and Jennifer do not possess a valid administrator certificate. Deficiency cited. The resident files had the required assessments, and admissions agreement. The facility has (2) fire extinguishers that were checked April 2024. There are no pools or bodies of water on the premises. The food supply was observed to be sufficient as there was a 2-day supply of perishables and and 7-day supply of non-perishable food items. The governing body was observed to be in good standing. The facility was observed to be clean, clutter and odor free. Indoor and outdoor passageways are free of obstructions and the physical plant is in good repair. The sharps, medications and other hazardous items were observed to be locked and inaccessible to residents in care. The hot water temperature in the resident bathrooms measured at 112- and 116.9-degrees Fahrenheit. The facility was observe to have valid liability insurance that expires on 12/18/25, in addition to having the required postings. The emergency disaster plan LIC610E requires to be updated as the form used was from 2007. An updated emergency disaster plan is due to the department by 5pm on 03/04/25. In addition the Administrator's are encouraged to conduct a review of records for both staff and residents to ensure that they are in compliance. LPA provided the LIC311F-RCFE, Records to be maintained at the facility for reference. There was no record of the facility conducting emergency disaster drills, as there were no logs available for LPA to review during today's visit. deficiency cited. Based on today's inspection a citation will be issued on the attached 809D, in accordance with the California Code of Regulations (Title 22, Division 6, Chapter 8). An exit interview was conducted where a copy of this report, and appeal right and LIC9098--proof of corrections form was reviewed and provided to caregiver Asuncion Buscaino.