Routine inspection·December 19, 2023

Licensing Program Analyst (LPA) Michael Hood arrived at the facility unannounced on 12/19/23 to conduct a Required-1 Year Inspection utilizing the inspection tool. LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. There are nine (9) bedrooms and five (5) 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 112.6 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, cleaning products, and other toxins to be locked away and inaccessible to residents. LPA observed the backyard and perimeter of the care home. LPA observed smoke detectors to be operational in the care home. First aid kit is maintained and ready for emergency use. 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. As a result of today's inspection, a deficiency is being cited pursuant to California Code of Regulations, Title 22, Section 87203 regarding obstruction of fire exits in bedroom 1 and side gate, and carbon monoxide detectors not being installed. Deficiency is listed on 809-D. An immediate civil penalty per Health and Safety Code § 1548 in the amount of $500 for the date of 12/19/2023 is assessed for a violation that the department determines was a fire clearance violation. Exit interview was conducted. A copy of this report and appeal rights were provided. Signatures on these forms acknowledges receipt of these documents.