Routine inspection·June 17, 2023

Licensing Program Analyst (LPA) Jacqueline Shaw Ross arrived at the facility to conduct an annual inspection. LPA met with caregiver, Jocelyn Estepa. Licensee Stan Estepa arrived shortly. LPA explained the purpose of the visit and was granted entry into the facility. The facility is licensed for five (5) elderly residents, in which two (2) residents may be non-ambulatory. The facility has a hospice waiver for two residents. Current census is two(2). The facility is a one story, five (5) bedroom two (2) bathroom home. The facility was inspected inside and out. LPA conducted staff and client interviews. The facility appears clean and free of odors. Staff present have criminal record clearances and are appropriately associated to the facility. Client bedrooms are clean and appropriately furnished. Food supplies are sufficient. LPA observed all toxic chemicals and other hazards secured and inaccessible to clients. Water temperature was measured and deemed appropriate. Furniture in the facility is in good repair. Outdoor space is free of hazards. LPA inspected the staff and client records. Staff files had the required documentation including First Aid Certifications and training documents. Client records had required documentation and files were up to date. LPA inspected medications and during the inspection, the LPA observed the following deficiencies: -The facility had medication pills that were pre-prepared and stored in a cup - not in its original container. -The facility had a PRN medication on hand, constipation cream - not listed on the Medical Administration Record (MAR) . Based on observations made by LPA, the facility was cited and deficiencies noted on LIC809D. An exit interview was conducted with the Caregiver and Licensee, and a copy of this report, LIC809D, and appeal rights were provided.