Routine inspection·December 3, 2024

Licensing Program Analysts (LPAs) Cassandra Mikkelson and Michael Hood arrived at the facility unannounced on 12/03/2024 to conduct a Required-1 Year Inspection utilizing the inspection tool. LPAs conducted an inspection of the care home to ensure compliance with Title 22 regulations. There are six (6) bedrooms and six (6) bathrooms for resident use. LPAs observed bedrooms to be properly furnished, with appropriate bedding and lighting. The bathrooms were in sanitary condition and properly maintained. Hot water temperature was observed to be 115.5 degrees F. LPAs checked the kitchen area for the ability to prepare and store food. Care home has required two (2) day perishable and seven (7) day non-perishable food supply on site. LPAs observed knives, cleaning products, and other toxins to be locked away and inaccessible to residents. LPAs observed the backyard and perimeter of the care home to be free of clutter and debris. LPAs observed smoke detectors and carbon monoxide detectors to be operational in the care home. First aid kit is maintained and ready for emergency use. LPAs checked medication storage and found medication to be locked away and inaccessible to the residents. LPAs reviewed five (5) resident files and three (3) staff files. Facility has a current copy of certificate of liability insurance and LPAs obtained a copy. As a result of this visit, a deficiency was cited pursuant to California Code of Regulations, Title 22, Division 6, Chapter 8. Deficiency is listed on 809-D pages. Exit interview was conducted with Administrator. A copy of this report and appeal rights were provided. Signatures on these forms acknowledges receipt of these documents.