Routine inspection (multi-day)·October 4, 2023

On 10/4/23 at approximately 12:00pm Licensing Program Analyst (LPA) Jennifer Fain arrived at this facility unannounced to conduct a continuation of an annual inspection visit. LPA met with the administrator Rosa-Leah Martinez-Davis 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 and outside of the facility to ensure compliance with Title 22 regulations. Facility has 2 bedrooms and 2 bathrooms for resident use. Facility currently provides care for 2 non ambulatory residents. During this inspection 2 resident files and 2 staffing files were reviewed for regulatory compliance. Staff files contained required contents including staff training requirements. All staff noted on LIC 500 contained criminal background clearances. Resident files reviewed contained all required contents including updated admission agreements, medical assessments, and updated appraisal forms as required. Smoke and carbon detectors were tested and in working order. Fire extinguisher was checked 7/14/23. LPA observed doors open to cleaning supplies. Medication storage area was observed to be locked and inaccessible to residents in care. First aid kit was observed to have adequate supplies and was accessible to staff. Facility does not contain any bodies of water. Facility has appropriate internet access available for resident use. LPA reviewed facility’s disaster plan to ensure regulatory compliance. Facility conducts quarterly fire drills. LPA provided Technical Assistance (TA) including, but not limited to, exceptions and waivers, change of administration, hospice and dementia care. The facility is not in compliance with Title 22 Regulations, and the deficiencies can be found on the LIC 809-D page. An exit interview was conducted with Rosa-Leah Martinez-Davis and a copy of the LIC 809 reports, LIC 809-D pages, and Appeals rights were provided.