Routine inspection·March 27, 2025

On 03/27/2025 at 08:45 AM, Licensing Program Analyst (LPA) Beena Singh made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA Singh met with a staff and was granted entry to the facility. Licensee Sushma Lal was contacted and arrived at the facility during the visit. At the time of the visit there were two (2) staff present, and five (5) residents present. The facility is a five (5) bedroom, two and a half (2 1/2) bathrooms with a kitchen/dining area and living room and garage. The facility is Residential Care Facility for the Elderly (RCFE). The facility is licensed for a capacity of six (6) of which two (2) can be ambulatory residents and four (4) can be non-ambulatory residents. The facility's approved for two (2) hospice waivers. The current census is five (5) residents. LPA was accompanied by Staff #1 (S1) to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing Division (CCLD). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 76 degrees Fahrenheit. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperature in a resident shared bathroom to be at 116-degree Fahrenheit. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Three (3) fire extinguishers were also observed at the facility. Posters such as personal rights, the CCLD complaint poster, Ombudsman poster labor laws, and the disaster plan were posted in a common area. ***Continuation in LIC809C *** Cleaning supplies and sharps were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. There is a Medicine cabinet with the resident’s medications locked. LPA observed the complete first aid kit and first aid book at the facility. Also, during the tour of the facility, LPA observed side fence gate unlocked. Food Service: More than seven (7) days’ supply of Non-perishable foods and more than two (2) days’ supply of perishable food supply were observed and sufficient for the number of residents in care. Care & Supervision: The facility has an Administrator present in the facility with appropriate and enough hours to appropriately manage the facility. The facility has enough staff to provide care and supervision to the residents in care. Record Review: LPA observed that the facility does have updated liability insurance dated/effective-5/1/2024-5/1/2025. Also, LPA observed no current fire drill or earthquake drill conducted at the facility. Deficiency will be issued. LPA reviewed three (3) resident files for admission agreements, updated physician reports, pre-placement appraisals and needs and services plans. LPA observed three (3) residents file reviewed do not have the required Pre-placement Appraisals and Needs and Services Plan. Deficiencies will be issued. LPA reviewed four (4) staff files for First Aid/CPR certification, criminal record clearance, training, and health screenings with tuberculosis (TB) test result. Medications/Medication Administration Record (MAR) were audited, and LPA observed no issue. Based on the observations made during today’s visit, deficiencies were issued per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809), LIC809D, and Appeal Rights were discussed and provided to Licensee Sushma Lal.