Routine inspection·January 11, 2024

Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to conduct an annual inspection. LPA Moleski met with facility administrator Ibifubara Jack and explained the purpose of the visit. LPA Moleski reviewed two resident files (R1-R2) and two staff files (S1-S3). LPA Moleski utilized the Licensing Information System to review this facility's staff roster. LPA Moleski observed that the two staff members present at the facility when LPA Moleski arrived (S1 and S2) were not associated to the facility. LPA Moleski observed that two staff members who were previously observed to be providing care (S3 and S4) were also not associated to the facility. LPA Moleski toured the facility with Jack and inspected common areas, the kitchen, bedrooms, bathrooms, and backyard areas. Furniture and furnishings were sufficient to meet the needs of residents. The facility temperature was 77 degrees Fahrenheit, which is within the required range of 68 and 85 degrees. The facility's water temperature measured 105 degrees Fahrenheit, which is within the required range of 105 and 120 degrees. LPA Moleski observed first aid supplies, a fully-charged and up-to-date fire extinguisher, and carbon monoxide/smoke detectors. LPA Moleski observed a minimum 2-day supply of perishable food and a minimum 7-day supply of nonperishable food. LPA Moleski observed a locked cabinet for the storage of medication. LPA Moleski observed locked cabinets for the storage of cleaning solutions and knives. LPA Moleski interviewed one staff member (S1) and one resident (R3). This facility is being cited per 22 CCR Section 87355(e)(2). A civil penalty in the amount of $500 for a violation of criminal record clearance requirements was assessed. An exit interview was held with Jack. Appeal rights and a copy of this report was left with Jack.