Routine inspection·December 14, 2023

Licensing Program Analyst (LPA) Ruth Wallace conducted an unannounced 1 Year Annual Inspection Visit. LPA met with Administrator and explained the purpose of the visit. Administrator assisted with today’s visit. The facility had a mitigation plan completed and approved on 6/17/2021. LPA toured and inspected the physical plant inside and outside with administrator to ensure there were no health and safety concerns. LPA observed the lounge area, lobby, and common areas. In addition, the kitchen areas, dining area, and activity room was toured. A review was conducted of the apartment sizes and different layouts. Each unit has mini-split air and heating unit. The medication room was toured. Kitchen pantry and walk-in freezer was toured for adequate food supplies and storage. LPA observed required furniture and lighting throughout the facility. The hot water temperature was measured at 113.4*F in resident apartment during this visit. Facility shall maintain the hot water temperature within the required range of 105-120*F. The temperature inside the facility measured at 73*F which was within the required range of 68-85*F. LPA observed supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days maintained on the premises. LPA observed the centrally stored medication areas to be locked and made inaccessible to the residents at this time. LPA observed the fire extinguisher(s) were last inspected on December 7, 2023. First aid kits were up to date. Smoke and carbon monoxide detector(s) in the facility were in good repair. Continued on 809-C Page 2 Continued from 809 - Page 2 LPA reviewed seven resident files and seven staff files, including criminal record clearances. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks are Fingerprint cleared and associated to the facility. LPA verified staff training for staff file reviews. LPA requested the following documents for facility file to be sent via email by December 20, 2023: LIC 308 Designation of Facility Responsibility, LIC 500 Personnel Report, LIC 610-E Emergency Disaster Plan, and Liability Insurance. ruth.wallace@dss.ca.gov Per the California Code of Regulations, Title 22, Division 6, Chapter 6, no violations cited during this visit. Exit interview held with administrator. A copy of report and LIC 811 (Confidential Names) left at facility.