Routine inspection·November 16, 2023

On 11/16/23, 2pm, Licensing Program Analyst (LPA) Arvin Villanueva arrived at the facility unannounced to conduct an annual inspection visit. LPA Villanueva met the administrator on paper, Bernadette Descargar and explained the purpose of the visit. LPA evaluated the physical plant with the administrator to ensure the health and safety of the residents in care. Facility is a single-story home with a fire clearance to serve 6 non-ambulatory elderly residents and has hospice waiver for 6 residents. Facility has 6 resident bedrooms, one staff bedroom and 3 bathrooms for resident use. Areas inspected are including but not limited to the kitchen, resident bedrooms; resident bathrooms, living and dining room and outdoor areas. LPA observed the facility to be free of odor, clean and in good repair. LPA observed that all rooms are equipped with the required furniture and sufficient lighting throughout the facility. LPA measured the water temperature to be between 105-120 degree Fahrenheit in one of the bathrooms. Temperature inside the facility was observed to be 74 degrees F. LPA observed sufficient seven day non-perishable and two day perishable food supplies. Carbon monoxide and smoke detectors are current and in compliance with fire safety. Fire extinguisher was last serviced on 1/24/23. First aid kit was checked and is complete. LPA observed centrally stored medications and toxins locked and secure from residents. LPA was sent annual required documents prior to annual inspection. During this inspection 4 resident files and 5 staffing files were reviewed for regulatory compliance. Staff files contained the required contents including staff training requirements. All staff noted on LIC 500 have criminal background clearances and are associated to this facility. {Con't on LIC809-C} {Con't from LIC809} Resident files reviewed contained required documents including updated admission agreements, medical assessments, and updated appraisal forms as required. Facility’s liability insurance is current and update to date per regulatory requirements. LPA observed personal rights poster. Facility has appropriate internet access available for resident use. Per California Code of Regulations, Title 22 and Health and Safety Codes, no deficiencies were observed during this visit. Interview was held with Bernadette Descargar and a copy of this report and appeal rights were provided.