Routine inspection·February 3, 2024

Licensing Program Analyst (LPA) Ruth Wallace conducted an unannounced Required 1 year Annual Inspection Visit. LPA met with Administrator and explained purpose of visit. The facility has an approved hospice waiver for two. LPA and administrator inspected physical plant to ensure the health and safety of the residents in care. 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 measured at 113.8 degrees F which meets the 105-120 degree Fahrenheit regulation. LPA observed sufficient seven day non-perishable and two day perishable food supplies. Fire extinguishers were inspected on 1/16/2024. Smoke detectors are current and in compliance with fire safety. LPA notes the facility had the required carbon monoxide detectors. First aid kit was checked and is complete. LPA observed centrally stored medications, toxins, and sharp knives kept locked and inaccessible to clients. LPA reviewed Fingerprint clearance and associations to the facility. Common touch surfaces are cleaned after each use. Fire drill last conducted on 12/12/2023. LPA reviewed three resident and two staff files, including criminal record clearances. LPA reviewed Fingerprint clearance and associations to the facility. First aid kit was checked and is complete. LPA requested the following updated documents to be submitted via email to community care licensing by February 12, 2024: LIC 308, LIC 500 - Personnel Report, Liability insurance Certificate, and Administrator Certificate. ruth.wallace@dss.ca.gov Per California Code of Regulations, Title 22 there were no deficiencies cited during today's inspection. An exit interview was conducted with administrator. A copy of this report and LIC 811(Confidential Names) was left with administrator at the facility.