Routine inspection·November 2, 2023

Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to conduct an annual required inspection. LPA attempted to open the LIC 809 as an annual required visit, however, due to technical difficulties, LPA had to open the LIC 809 as a case management - annual continuation. LPA was met by facility staff Stephanie Siewe, and explained the purpose of the visit. LPA was then met by Administrator (ADM) Justice. ADM and LPA Valerio toured the facility to ensure compliance with Title 22 regulations. LPA observed resident bedrooms to be equipped with a bed, night stand, closet space, a dresser, and lights. Common areas were observed to have necessary furniture and did not appear to be malodorous. LPA measured the hot water in 2 bathrooms, which was measured to be within the regulatory range of 105.0*F - 120.0*F. LPA observed the kitchen; knives were locked and inaccessible to residents in care. Lunch today was pasta shells with sauce, vegetables and ground meat and a half turkey sandwich. LPA observed 4 staff files, which had the required first aid/CPR training. LPA observed 3 resident files, which was observed to have all necessary files with current information and updated for year 2023. Residents were observed taking a nap, watching television, being assisted by a staff, and sitting in the backyard. LPA spoke to multiple residents during the visit. Technical Advisory was provided for the sink and shower for the bathroom located towards the back of the home. According to administrator, he had previously tried to fix the sink but believes the whole sink needs to be replaced. Administrator stated that they plan to replace the entire walk-in shower. Technical Advisory was provided for an emergency supply of food and water. Administrator stated he will obtain the emergency supply food/water from a wholesale store by COB. An exit interview was held, and a copy of the report was provided.