Routine inspection·February 22, 2024

Licensing Program Analyst (LPA) Janira Arreola conducted a required annual visit. LPA was greeted and was granted entry and met with Facility representative, Troy White and Administrator and Licensee Jacqueline White, who were informed of the purpose of the visit. At time of visit there were (2) residents and (4) staff present. The facility is a two story home with (4) bedrooms and (2) bathrooms with attached garage. The facility does not have a pool or fire arms. The facility serves elderly ages 60 and above. LPA conducted a tour of the interior and exterior and reviewed facility documents, and conducted staff and resident interviews. The following was observed: Physical Plant: Physical plant, floors, windows, and doors were observed to be clean and fixtures and furniture were present and in good repair. The facility's outdoor area was observed to be free of hazards. The carbon monoxide detector was located during the time of the visit. Medications, sharp and dangerous items are kept in locked area. Food Service: LPA observed facility kitchen had the ability to prepare food in clean environment and possessed equipment in good working condition. LPA observed the facility met the required 2-day supply of perishable and 7-day supply of non-perishable foods. Staffing: During the time of the visit, LPA interviewed staff, and reviewed background clearance. Based on record review and interview it was found that (2) staff who provide care and supervision to residents were not fingerprinted with the department and were present during the visit. A plan of correction was made and removal was confirmed with licensee. A deficiency was cited for the staff and civil penalty was issued in the amount of $500 per staff, totaling $1000. Additionally, licensee was unable to show LPA proof of (1) staff having a valid CPR and First aide card. This deficiency was issue and plan of correction was created with Licensee. Due to time constraints and observation, the facility visit will be continued on a different unannounced date. No other immediate health or safety risks were observed during the time of the visit. An exit interview was conducted with Facility representative, Troy White where this report, along with LIC809-D page, civil penalty form, appeal rights, LIC9098, and a copy of LIC311C was provided to the licensee.