Routine inspection·April 16, 2025

Licensing Program Analyst (LPA) Michael Hood arrived at the facility unannounced on April 16, 2025 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 five (5) bedrooms and three (3) 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 105.2 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. 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 reviewed two (2) residents' medications and observed medication storage to be locked away and inaccessible to the residents. LPA reviewed six (6) 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 87202(a)(1) due to the retention of six (6) non-ambulatory residents without fire clearance approval. Deficiency is listed on 809-D. Exit interview was conducted with House Manager. A copy of this report and appeal rights were provided. Signatures on these forms acknowledges receipt of these documents.