Routine inspection·August 23, 2023

On 8/23/2023, Licensing Program Analyst (LPA) Janette Romero arrived unannounced at the facility to conduct an annual required visit. LPA was greeted and granted entry by Caregiver Gemma Baltazar who was informed of the purpose of visit. During the visit, there was three (3) residents and (2) staff present and LPA was informed that one (1) resident was at day program. The facility is approved to care for four (4) non-ambulatory residents. LPA toured the facility inside and out. The facility is made up of three (3) client bedrooms, two (2) bathrooms, two (2) living rooms, a kitchen, dining room and garage. During the visit, LPA observed the following: Kitchen: LPA observed kitchen area to be clean. Food is stored in a safe and healthful manner. LPA observed the facility had a 2-day supply of perishable foods and 7-day of non-perishable food items. Knives are secured in a locked kitchen drawer. Dining and Living room: LPA toured the dining room and living/family rooms. LPA observed area to be clean and furniture in good condition. LPA observed residents sitting in the living room watching television. Detectors : Facility had a fire alarm system. Carbon monoxide and smoke detector were tested and functioning properly. Continued on LIC809-C. Centrally Stored Medications: LPA observed a first aid kit with required components. Medications were secured in a kitchen cabinet. LPA reviewed physical medications for two (2) resident as well as Medication Administration Record, no discrepancies discovered. Bedrooms : Resident bedrooms were each furnished with a bed, chair, closet, clothing storage and lighting. Bathrooms: Bathrooms have a working toilet, wash basins, and were equipped with a grab bars in the shower. The hot water temperature measured at 110- and 112-degrees Fahrenheit. The facility plenty of clean towels, blankets, and linen, available in different colors for the residents in care. Laundry/Garage : LPA toured garage. Washing machine and dryer are in good repair and stored in the garage. Emergency food supplies and water are also stored in the garage. Records: Staff present have a criminal record clearance on file and are associated to the facility. The CPR/First Aid certification for Staff #1 expired on 7/10/2023. Deficiency cited. The facility's last earthquake and fire drill was conducted on 8/5/2023. Yard/Outside Area: Shaded seating area is available for the residents to sit and relax. . No bodies of water were observed. 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. Residents’ Cash Resources : The facility safeguards residents’ cash resources. LPA reviewed Record of Client’s/Resident’s Safeguarded Cash Resources (LIC 405) for all residents and did not discover any discrepancies. During today’s visit, LPA observed one (1) deficiency faulting the facility. An exit interview was conducted, and a copy of this report was reviewed and provided to Administrator Ko along with an LIC809-D and Appeals Rights.