Routine inspection·February 15, 2023

Licensing Program Analysts (LPAs) Avelina Martinez, Arielle Pascua, and Pang Lee made an unannounced visit to this facility to conduct an annual inspection on 02/15/2023 at 9:35 AM. LPAs met with Dessi Minitrova and stated the purpose of today’s visit. LPAs inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, activity room, and outside courtyards of the facility to ensure compliance with Title 22 regulations. Administrator holds current certificate and expires on 05/11/2024. The facility is licensed for six non-ambulatory residents and has a hospice waiver for two. There are currently four residents who reside at this facility. LPA Martinez toured the facility with Dessi Dimitrova on 02/15/2023 at 10:00 AM. The facility had Covid-19 postings throughout the facility. The facility has one main Covid-19 screening entry point. LPAs inspected smoke detectors and and carbon detectors, which were in good repair. The fire extinguisher did not have an inspection tag. The facility had an adequate food supply. LPAs reviewed staff and resident files and they were up to date. The facility has first aid kit and a locked medication cabinet. The facility water temperature measured at 105 degrees and the facility temperature measured at 76 degrees. The facility needs some cleaning and unused furniture needs to removed from the residents patio area. The exterior emergency exit door opens, however, the latch needs to be repaired. Technical violations were given, as the Licensee is currently working on removing unused furniture and repairing exterior gate. The facility has a public telephone and has an area for activities. As a result of this visit, the following deficiency was cited, per California Code of Regulations, Title 22 and Health and Safety Code. An exit interview was conducted and copy of the 809 report, 809D page, and appeals rights were given to administrator at the end of visit.