Routine inspection·May 7, 2025

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced, required Annual Inspection. The facility file and personnel report was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to Administrator Natalie Bond. Co-Administrator Todd Brooks arrived later during the visit. The facility's license shows a capacity of six (6) non-ambulatory residents, one (1) of which may be bedridden. Bedridden resident may reside in bedroom #1. The facility additionally has a hospice waiver for two (2) residents with total care addendum. During today's inspection there were six (6) residents in care. LPA and Administrator Bond toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Hot water temperature at taps accessible to clients were all compliant: common bathroom sink was 119F. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility contained at least two (2) days of perishable food, and at least seven (7) days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. However, LPA observed that knives were stored in an unsecured cabinet, accessible to residents in care. A Deficiency was cited per California Code of Regulations (CCR) 87309(a). [Continued on LIC 809-C] [Continued from LIC 809] No toxic chemicals or poisons were accessible to clients.  Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per Administrator Bond, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguisher was serviced within the last 12 months. First aid kit was incomplete and LPA provided a Technical Violation (TV). Required licensing postings were observed in visible areas of the facility. LPA interviewed one (1) staff and two (2) clients, and interviews did not reveal any licensing or regulatory concerns. LPA reviewed facility records. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. LPA discussed with Administrator Bond about the Technical Support Program offered by the Department, and created a referral for the facility. A Deficiency and a Technical Violation (TV) were cited during the inspection. An exit interview was conducted with Administrator Bond to whom a copy of this report, the TV form, and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.