Routine inspection·November 20, 2023

Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a required annual inspection. LPA met with Carina Davis, Administrator and discussed the purpose of the visit. The facility is a Residential Care Facility for the Elderly (RCFE). License capacity of (6) with a current census of (5) and a hospice waiver for (2). LPA conducted an overall inspection of the facility, which included, but was not limited to, the following: Physical Plant: Indoor and outdoor passageways are free of obstruction. The facility has sufficient lighting and is maintained at a comfortable temperature. Resident’s bathrooms were operating in safe and sanitary conditions. The hot water temperature in residents' bathrooms measured between 105 and 109 degrees F. Resident’s bedrooms have sufficient lighting and furniture in good repair. Facility has operating carbon monoxide alarms and telephone service. The facility has sufficient linen, towels, and personal hygiene items for residents. The facility has posted in a common area, Community Care Licensing complaint poster, Ombudsman poster, disaster evacuation plan and emergency telephone numbers, facility license. The facility is enclosed with self-latching gates. Outdoor shaded area is sufficient for resident activities. Care & Supervision : Facility has 24-hour/7 days a week care staff. Food Service: Facility has sufficient non-perishable and perishable food supply for residents in care. The refrigerator and freezer are operating in a healthful manner. Pesticides and other cleaning solutions were kept locked and stored away from food areas. Record Review: (4) resident files were observed complete. Record review of (2) staff files reveals, the Licensee did not maintain documentation of criminal record clearance or exemptions for staff #1(S1) and staff#2(S2) on file. Verification of criminal record clearance for S1 and S2 was verbally provided by Department personnel. Medical Related Services : All medication is centrally stored and kept locked in a cabinet. Based on LPA observations and record review, a deficiency is being cited per Title 22, Division 6 of The California Code of Regulations. A plan of correction was reviewed with Administrator Davis. An exit interview was conducted where licensing reports (LIC809/LIC809-D/LIC9102) were discussed. A copy of the licensing reports with appeal rights was provided to the Administrator at the conclusion of the visit.