Routine inspection·December 20, 2023

Licensing Program Analyst (LPA) Jamie Ivey Canady made an unannounced visit to this facility to conduct an annual required inspection on 12/20/2023. LPA met with Mary Jane Apuya and explained the purpose of today's visit. LPA inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, activity room, and outside courtyard of the facility to ensure compliance with Title 22 regulations. LPA toured the facility with Mary Jane Apuya on 12/20/2023 at 9:21am. Administrator holds current certificate and expires on 11/01/2024. The facility is licensed for 6 non-ambulatory residents, and has a hospice waiver for 1 resident. There are currently 4 residents who reside at this facility. There are no residents on hospice. LPA requested and received current facility LIC500. The facility has an infection control plan in place. The facility has one main screening entry point, and furniture is spaced 6 feet apart. The facility smoke and carbon detectors are in good repair. The facility fire extinguisher is in good repair. The facility has an adequate food supply and has emergency food and water kit. The facility has a first aid kit. Water temperature is 110 degrees. Facility temperature is 73 degrees. The facility has a locked medication cabinet, and the facility has an updated Centrally Stored Medication and Destruction record for each resident in each resident file. 4 resident and 3 staff files have all required documents. The facility also has the required postings through out the facility. The facility is clean and sanitary. The exterior emergency exits are clear of debris. Per California Code of Regulations (CCRs) - Title 22, no deficiencies cited. Exit interview was held and a copy of report was given to facility administrator Mary Jane Apuya.