Routine inspection·December 4, 2024

On 12/4/2024, Licensing Program Analyst (LPA) Arvin Villanueva arrived to the facility unannounced to conduct an annual required inspection. LPA met with Licensee Delia Quinley and Administrator Katherine Caprio and stated the purpose of the visit. During this visit, all residents in care were out in the community. LPA evaluated the physical plant with Licensee and Administrator to ensure the health and safety of the residents in care. Areas inspected include but not limited to the kitchen, resident bedrooms, resident bathrooms, living and dining room and outdoor areas. The facility is a one-story home located in a residential neighborhood. Facility is fire cleared to retain/admit 4 residents with approved hospice waiver for 2 residents. Facility has 4 bedrooms, 1 of which was approved for non-ambulatory. Facility has 2 bathrooms for resident use. 1 of which is located in the master bedroom. LPA observed the facility to be free of odor, clean and in good repair at this time. LPA observed all resident bedrooms to be equipped with the required furniture and sufficient lighting throughout the facility. LPA inspected 2 of 2 bathrooms and were observed to be equipped with slip resistant flooring and overall in good repair at this time. Hot water temperature in 1 resident bathroom was measured at 113 degrees F. Room temperature was observed at 66 degrees F. LPA observed sufficient seven day non-perishable and two day perishable food supplies. Fire extinguishers were observed and were last inspected on 8/30/24. Smoke and carbon monoxide detectors were observed. LPA observed centrally stored medications, toxins, and sharp objects were kept locked and inaccessible to residents in care. Fireplace was observed to be screened and non-operational at this time. {1 of 2} Outdoor areas were observed to be clean and clear of hazards at this time. No bodies of water was observed at this time. Fence and gates were observed to be in good repair at this time. LPA observed activity supplies for residents. LPA observed outdoor furniture and outdoor activity area was observed to be spacious for resident use. Review of 3 sample resident files (R1, R2, R3) which include review of Admission Agreement, Physician Reports, Needs and Services Plan, Centrally Stored Medication Record and Ambulatory Status. No hospice residents at this time. No issues were noted. Medication review of 3 sample residents which includes review of facility's medication log, centrally stored medication record, and physician orders for over-the-counter medications. No issues were noted at this time. Review of 3 sample staff files (S1, S2, and S3) include review of background clearance, First Aid/CPR certificate, Health Screen, Initial and Ongoing Training. Administrator Certificate is current. No issues were noted at this time. Facility conducts monthly disaster drill and last drill was on 12/2/24. Facility has infection control plan. Prior to this visit, Administrator provided a copy of current Liability Insurance Certificate, Surety Bond, LIC500 and LIC308 to LPA. Per the California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies were observed during today's visit. Exit interview was conducted and a copy of the report was provided upon exit. {2 of 2}