Routine inspection·January 13, 2023

Licensed Program Analyst (LPA) Victoria Brown arrived unannounced to conduct a Required - 1 Year visit on 1/13/23 at 10:00 am. LPA met with Remedios Sobrebena, Cynthia Navarro Caregivers and Carmen Navarro, Licensee/Administrator and stated the purpose of the visit. The facility is licensed for a capacity of 6 residents. LPA toured and inspected the physical plant inside and outside to ensure there are no safety hazards to residents. LPA observed and interviewed residents during this visit. LPA observed 2-day perishables and 7-day non-perishables. The temperature inside the facility was observed to be at 73* F which is within the required range of 68-85*F. The hot water temperature was measured at 120.0*F which is within the required range of 105-120*F. Licensee/Administrator turned down the hot water heater during this visit. LPA observed fire extinguisher(s), pull alarm system, smoke and carbon monoxide detectors, and central heating and air in the facility. LPA observed fire drill is conducted monthly. LPA observed Designation Of Facility Responsibility LIC308. LPA observed the centrally stored medications area to be locked and inaccessible to residents. The first aid kit contained the required items such as sterile dressings, bandages, adhesive tape, scissors, tweezers, thermometers, antiseptic solution and guide. Upon a file review the following items were discussed to be submitted with any changes annually: Designation of Facility Responsibility (LIC308) Liability Insurance Personnel Report (LIC500) Administrator Certificate-Updated Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, no deficiencies cited during this visit. Exit interview held with Carmen Navarro, Licensee/Administrator. A copy of todays’ report provided.