Routine inspection·June 12, 2025

On 06/12/2025 at 1:15 PM, Licensing Program Analyst (LPA) Pang Lee and Shakaricka Hughes arrived at the facility to conduct an unannounced annual inspection. LPA's met with caregiver Maria Sanchez and explained the purpose of the visit. The facility administrator was present in the facility. The current census is 6 with 3 facility staff. This facility is a single story building licensed to serve (6) non-ambulatory residents and (4) hospice residents. LPA's inspected the physical plant including but not limited to the common area, kitchen, dining area, resident bedrooms, resident bathrooms, laundry room and outside courtyards of the facility to ensure compliance with Title 22 regulations. LPA's observed the facility to be free of odor, clean and in good repair. LPA's observed bedrooms to be properly furnished with appropriate bedding and lighting. There are no bodies of water present. LPA's toured the kitchen and observed sufficient seven-day non-perishable and two-day perishable food supplies. Hot water temperature was measured at 107.6 degrees Fahrenheit in resident bathroom sink, which is within the required regulation of 105 to 120 degrees Fahrenheit. Grab bars and non-slip mat were observed to be stable and in good repair at this time. Smoke and carbon monoxide detectors are in compliance with fire safety.  The fire extinguisher is located in the common area and was last serviced on 01/31/2025. LPA's observed the facility has a public telephone in the kitchen area and the facility has the required posters posted. Facility thermostat was observed at 78 degrees Fahrenheit. Continuation on 809-C LPA's observed toxins located on the porch patio and kept locked and inaccessible to residents in a storage. LPA's observed sharp knives kept locked in the kitchen and inaccessible to residents. LPA's checked medication storage and found medication to be locked away and inaccessible to residents. LPA's reviewed 3 out of 6 residents medications and the medication administration record (MAR) was complete. The first aid kit was checked and contained the required components. LPA's requested resident and staff files for review. LPA's reviewed 6 out of 6 resident files and they were complete. LPA's reviewed 5 staff files, and it was complete. During staff file review, it was observed that Staff (S5) did not have a LIC 503 with TB test or Chest X-ray results. Administrator states, that S5 has not started working at the facility as of 06/12/2025, per administrator S5 date of hire was May 01, 2025. Administrator states TB results or Chest X-ray will be provided prior to S5 starting at the care facility. LPA's reviewed staff criminal record clearances, and a review of staff records indicates that all facility staff or other individuals who require caregiver background checks are fingerprint cleared. The following documents will be email to LPA by 06/26/2025 end of day 5:00 PM: (1) Proof of Current Liability Insurance As a result of this annual visit, the facility is in compliance with Title 22 Regulations. An exit interview was conducted with Maria Sanchez and a copy of these LIC 809, LIC 809-C, LIC 9102 TA, were provided to the facility.