Routine inspection·July 21, 2023

On 7/21/23 at approximately 11:20am Licensing Program Analyst (LPA) Jennifer Fain arrived at this facility unannounced to conduct an annual inspection visit. LPA met with the Niomi Massaquoi, Administrator Designee, and explained the purpose of the visit. LPA inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms, resident bathrooms, laundry room, living area, common TV area, and outside of the facility to ensure compliance with Title 22 regulations. Facility has 6 bedrooms and 2 bathrooms for resident use. Facility currently provides care for 1 ambulatory resident, 4 non ambulatory residents, 0 hospice, and 1 bedridden resident. Facility Observation: Upon entry the residents were gathered in the living room or in their own rooms watching tv. A resident requested tea; staff confirmed the way they wanted their tea and then served it. Lunch service was observed with some residents taking their meal at the dining table and some in their rooms. Some residents had blankets that they used and set aside as they needed throughout the day. Residents in rooms were checked on several times an hour. Water temperature in common bathroom reads 114.8F* which is within the regulated temperature range of 105*F to 120*. Temperature on the heating and air unit read 69*F. LPA observed the facility to have adequate food supply. Resident rooms were sanitary and had the required furniture and furnishings. The facility common areas were clean and furnished. Smoke and carbon detectors were tested and in working order. The fire extinguisher was serviced January 30, 2023. All toxins and other dangerous items including sharp objects were locked and inaccessible to residents in care. Medication storage area was observed to be locked and inaccessible to residents in care. Medications were reviewed and contained accompanying regulatory required Physician’s orders. First aid kit was observed to have adequate supplies and was accessible to staff. Facility does not contain any bodies of water. LPA observed personal rights, resident council and complaint information posted. Facility has appropriate internet access available for resident use. Facility conducts quarterly fire drills. LPA requested an updated copy of LIC 308, 610E and Liability Insurance to be emailed to Jennifer.Fain@dss.ca.gov This annual inspection will be continued at a later date. An exit interview was held and a report was given to Niomi Massaquoi.