Routine inspection·September 18, 2024

Licensing Program Analyst (LPA) Sarina Ramirez made an unannounced visit to the facility to conduct a required annual inspection. LPA met with Administrator Joi Mae Gubalane and discussed the purpose of the visit. The facility is a Residential Care Facility for the Elderly (RCFE) with a license capacity of (6), a current census of (6). LPA Ramirez conducted an overall inspection of the facility, which included, but was not limited to, the following: Physical Plant/Environment: Indoor and outdoor passageways are free of obstruction. The facility has no swimming pool or similar bodies of water. Outdoor shaded area is sufficient for resident activities. The facility has sufficient lighting and is maintained at a comfortable temperature. The facility is equipped with operating smoke detectors/carbon monoxide alarms and telephone service. Resident’s showers, toilets, and hand washing areas were operating properly. The hot water temperature in (2) residents bathrooms measured at 105.3 and 107.3 degrees F. Four (4) resident’s bedrooms had beds, bed linen, chairs, dresser, storage space and sufficient lighting. The facility has sufficient linens, towels, and personal hygiene items for residents. The facility has posted in a common area, CCLD complaint poster, Ombudsman poster, facility license, disaster facility sketch, and residents rights. Food Service: Facility kitchen and dining areas are maintained clean. The facility has sufficient non-perishable and perishable food supply for residents in care. Sharps and chemicals were kept locked and inaccessible to residents in care. Continuation on LIC – 809C: Care & Supervision : Facility has 24-hour/7days a week care staff. Medical Related Services : Resident’s medications are labeled and centrally stored in a locked cabinet. Record Review: Three (3) Staff files reviewed, staff #2 has missing CPR certificate, missing health screening, and missing training documentation; deficiency will be cited. Six (6) Resident files reviewed were observed to be complete. Based on observations and record review deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted where reports (LIC809 & LIC809-D) were discussed and copies were provided with appeal rights to Administrator Joi Mae Gubalane