Routine inspection·April 3, 2024

Licensing Program Analyst (LPA) Michael Hood arrived at the facility unannounced on 4/3/24 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 six (6) bedrooms and eight (8) 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 111 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 to be free of clutter and debris. LPA observed smoke detectors and carbon monoxide 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 87355(d)(3) regarding one (1) caregiver not obtaining a criminal background clearance prior to employment. Deficiency is listed on 809-D. A civil penalty per Health and Safety Code § 1568.09 in the amount of $200 for the date of 4/3/2024 is assessed for a criminal background clearance violation. Exit interview was conducted with Operations Director. A copy of this report and appeal rights were provided. Signatures on these forms acknowledges receipt of these documents.