Routine inspection·January 19, 2024

On 01/19/2024 at 8:21 AM, Licensing Program Analyst (LPA) Pang Lee arrived at the facility to conduct an unannounced annual inspection. LPA Lee met administrator Taty Sael who assisted with today’s visit. LPA Lee explained the purpose of the visit. Administrator certificate # is 6002575740 and will expire on 06/02/2025. The current census is 5 with 2 facility staff. This facility is a single story building licensed to serve six (6) non-ambulatory residents and approved for hospice waiver for three residents in care. LPA 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 observed the facility to be free of odor, clean and in good repair. LPA observed bedrooms to be properly furnished with appropriate bedding and lighting. There are no bodies of water present. LPA toured the kitchen and observed sufficient two-day perishable and seven-day non-perishable food supplies. LPA Lee observed sharp knives kept locked. Hot water temperature was measured at 117.5 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 entry way and was last serviced on 12/19/2023. The last fire drill was conducted on 12/29/2023. LPA observed the facility has a has a public telephone in the kitchen and the facility has the required posters posted. Facility thermostat observed at 70 degrees Fahrenheit. LPA Lee observed toxins made accessible to residents in care. LPA Lee observed nail polish remover and Vicks VapoRub in the linen closet. Furthermore, LPA Lee observed laundry detergent, plant food, fabric softener, and fabric odor eliminator in the garage made accessible to residents in care. During today’s visit LPA Lee observed administrator removed all toxins that was made accessible to resident and locked them in a locked cabinet. Continued LIC 809-C LPA checked medication storage and found medication to be locked away and inaccessible to residents. LPA reviewed and compared 3 out of 5 residents LIC 622 Centrally Stored Medication and Destruction Record with residents medications and is was complete and accurate. The first aid kit was checked and contained all the required components. LPA requested residents and staff files for review. LPA reviewed 5 out of 5 resident files and 3 staff files and they were all complete. LPA Lee 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 and associated to the facility. The following documents will be email to LPA Lee ( pang.lee@dss.ca.gov ) by 01/26/2025 by 5:00 PM by end of day: (1) LIC 308 Designation of Administrative Responsibility (2) LIC 500 Personnel Report (3) Copy of Administrator Certificate (4) LIC 610 Emergency Disaster Plan (5) Proof of Current Liability Insurance As a result of this annual visit, the facility is not in compliance with Title 22 Regulation, and the deficiencies can be found on the LIC 809 D page. An exit interview was conducted, and a copy of these LIC 809 reports, LIC 809-D page, and Appeals rights were provided to the facility.