Routine inspection·July 1, 2021

Licensing Program Analyst (LPA) Anthony Tuck Island arrived to conduct an unannounced annual/random inspection on 07/01/2021. LPA met with Unaisi Wagalala and explained the purpose of the visit. Unaisi Waqalala is the Administrator and holds certificate #60564441740 that expires on 06/30/23 This facility is a single story building licensed to serve six (6) non-ambulatory residents and has a waiver for 1 hospice. LPA toured the physical plant including but not limited to two resident bedrooms, two resident bathrooms, garage and backyard area. LPA observed the facility to be free of odor, clean and in good repair. LPA observed sufficient furniture and lighting throughout the facility. There are no bodies of water present. LPA observed sufficient seven day non-perishable and two day perishable food supplies. Hot water temperature was measured at 106.5 degrees Fahrenheit in resident bathroom sink, which is within the required regulation of 105 to 120 degrees Fahrenheit. Fire extinguishers and smoke and carbon monoxide detectors are in compliance with fire safety. Fire extinguisher last serviced 06/04/2021 Thermostat observed at (76.1) degrees Fahrenheit. LPA observed centrally stored medications, toxins and sharp knives kept locked and inaccessible to clients. LPA reviewed resident and staff files, including criminal record clearances. LPA reviewed staff associations to the facility. First aid kit was checked and is complete. The following forms were requested during today's visit on 07/01/2021: LIC 308 LIC 500 Copy of Admin Certificate copy of control of property, copy of liability insurance. Per California Code of Regulations, Title 22 Division 6, Chapter 8, no deficiencies were cited. Exit interview held with Unaisi Waqalala and a copy of report given at the conclusion of the visit.