Routine inspection·October 5, 2023

Licensing Program Analyst (LPA) Michael Hood arrived at the facility unannounced on 10/05/23 to conduct a Required-1 Year Inspection utilizing the inspection tool. LPA spoke with Administrator, Qiao Jiao, via telephone call. Administrator stated that they could not attend visit and gave permission for caregiver, Saturnina Daroy Tamayo , to sign report. LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. There are six bedrooms and six bathrooms for resident use. LPA observed bedrooms to be properly furnished, with appropriate bedding and lighting. The bathrooms were in sanitary condition and properly maintained. Hot water temperature was observed to be 115.6 degrees F. LPA checked the kitchen area for the ability to prepare and store food. Care home has required two (2) day perishable and seven (7) day non-perishable food supply on cite. LPA observed knives to be locked away and inaccessible to residents. LPA observed the backyard and perimeter of the care home to be free of clutter and debris. LPA observed smoke detectors and carbon monoxide detectors to be operational in the care home. LPA checked medication storage and found medication to be locked away and inaccessible to the residents. LPA reviewed three (3) resident files and two (2) staff files. Facility has a current copy of certificate of liability insurance and LPA requested a copy. LPA also requested a staff roster and updated emergency disaster plan during inspection. As a result of today's inspection, a deficiency is being cited pursuant to California Code of Regulations, Title 22, Section 87309(a) regarding chemicals being accessible to residents. Deficiency is listed on 809-D. Exit interview was conducted. A copy of this report and appeal rights were provided. Signatures on these forms acknowledges receipt of these documents.