Routine inspection·May 9, 2025

Licensing Program Analyst (LPA) Holly Williams arrived unannounced to conduct an annual inspection. LPA Williams met Facility Designated Administrator (FDA) Lucas Yacub and a brief interview was conducted. LPA Williams reviewed four resident files (R1-R4) and two staff files (S1-S2). The census is 4 residents and the facility has a hospice waiver for 6. LPA Williams toured the facility with the FDA and inspected common areas, the kitchen, bedrooms, bathrooms, and backyard areas. Furniture and furnishings were sufficient to meet the needs of residents. The facility temperature was 73 degrees Fahrenheit, which is within the required range of 68 and 85 degrees. The facility's water temperature measured 120 degrees Fahrenheit, which is within the required range of 105 and 120 degrees. LPA Williams observed first aid supplies, a fully-charged and up-to-date fire extinguisher, and working carbon monoxide/smoke detectors. LPA Williams observed a minimum 2-day supply of perishable food and a minimum 7-day supply of nonperishable food. While touring the facility LPA observed medication in 3 out of the 4 residents rooms. LPA observed the medication cart unlocked and pre poured medication in the medication cart and pre poured medication in the unlocked drawer in the kitchen. LPA Williams observed unlocked cabinets for the storage of cleaning solutions and knives in the kitchen, unlocked cleaning solutions in the 2 out of 3 bathrooms. In the 2 laundry rooms LPA observed unlocked detergent and rat poisons. LPA Williams interviewed staff member (S1) and 2 resident (R1-R2). The following deficiencies were observed and cited on the following LIC 809-D pursuant to Title 22 Rules and Regulations, Health and Safety Codes. Appeal rights were printed and a copy was given to the facility designated Administrator at this time. Exit Interview