Routine inspection·October 20, 2022

Licensing Program Analyst (LPA) Ruth Wallace conducted unannounced Required 1 Year Annual Inspection Visit. LPA explained purpose of visit with Administrator. Administrator Certificate #: 6001968740, Exp: 04/23/2023). There are currently 4 residents who reside at this facility. There are no residents who have restricted health care conditions and no residents who are currently receiving wound care. This facility has a hospice wavier for four (4) and currently has two (2) residents on Hospice. LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, and kitchen. Bathrooms and bedrooms were clean and in good repair. There is a locked storage for medications and toxins. Food supply is adequate for 2 day perishable and 7 day nonperishable. Smoke alarms were checked and in good working order. LPA observed an adequate amount of linens. Hot water temperature measures at 110.3 degrees F. This facility is operating within the scope of their license. LPA observed the fire extinguisher(s) which were inspected on 11/2/22, smoke and carbon monoxide detector(s) in the home. Last fire drill conducted 7/24/22. LPA reviewed two (2) resident and two (2) staff records. Resident files were found to be complete and current. A review of staff records indicates that all facility staff have received criminal record clearances and/or are associated to this facility. Staff records reviewed indicated current first aid certificates. Facility is conducted staff training as required. Per the California Code of Regulations, Title 22, Division 6, Chapter 8, no violations were observed during this visit. Exit interview held with administrator and a copy of report given to administrator.