Routine inspection·February 25, 2025

Licensing Program Analysts (LPAs) Sarina Ramirez and Eldin Serrano made an unannounced visit to the facility to conduct a required annual inspection. LPAs met Director of Operations Samuel Goings, and discussed the purpose of the visit. The facility is a Residential Care Facility for Elderly (RCFE) with a license capacity of (62), and a current census of (51). LPAs conducted a general inspection of facility, which included, but was not limited to, the following: Physical Plant: Indoor and outdoor passageways were kept free of obstruction. The facility has no swimming pool or similar bodies of water. The facility has sufficient space for resident activities. Four (4) resident bedrooms and Four (4) resident’s bathrooms were inspected, hot water temperature measured at 105.9 degrees F. The facility is equipped with operating smoke/carbon monoxide alarms, laundry equipment, and telephone service. The facility has posted in a common area, personal rights, facility sketch, the Community Care Licensing complaint poster, Ombudsman poster, menu, activities, and license. Cleaning supplies and sharps were kept inaccessible to residents in care. Last fire drill was conducted 02/12/25. Food Service: Kitchen and dining areas were maintained cleaned. Non-perishable and perishable food supply is sufficient for number of residents in care. Facility refrigerators and freezers were maintained in operating condition. The facility has posted a weekly menu. Health Related services: LPAs reviewed four (4) resident medications. Resident’s medications are labeled and centrally stored in a locked room; however staff are not administering medications at prescribed times or signing after administering; deficiency will be issued. Continuation on LIC809-C Record Review: Seven (7) resident files reviewed were observed to be complete. Seven (7) staff files reviewed were observed to be incomplete, S1 had a missing health screening report signed by a physician, technical violation will be issued. Based on LPAs observations and records reviewed, deficiencies are being cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted where this report (LIC809) and LIC 809D was discussed to Director of Operations Samuel Goings. Copies of the reports were provided with appeal rights to the Director of Operations at the conclusion of the visit.