Routine inspection·September 27, 2023

Licensing Program Analyst (LPA) Jacqueline Shaw Ross arrived to the facility to conduct a required annual inspection and was greeted by Caregiver, Norma Tosoc. Licensee I Chen Lee and Administrator William Lee arrived shortly. Present at the facility were two (2) staff and five (5) clients. The facility is approved for six (6) non-ambulatory elderly residents; age 60 and above. Hospice care waiver is approved for one (1). LPA conducted staff and client interviews. The facility is a six (6) bedroom, three (3) bathroom house. Each client has a private room. LPA toured the facility and conducted a general overall inspection of the facility inside and outside. Passageways were observed to be free of obstructions. LPA observed each bedroom to be clean and odor free with the required furnishings. Furniture throughout the facility was in good repair. The facility temperate was 75 degrees. Hot water temperature tested at 122.5 degrees Fahrenheit which is above the maximum hot water temperature of 120 degrees; however LPA observed hot water warning signs posted throughout all bathrooms. Each bathroom contained grab bars for each toilet, bathtub and shower; and non-skid mats or strips in shower or bathtub. LPA observed the kitchen in its entirety. The kitchen appeared clean and odor free. Dishes, cups, pots and pans were observed to be of good quality and quantity. The facility contains a sufficient supply of perishable and non-perishable foods. The facility has an in-ground pool in the back yard secured with fencing that is in compliant with the Health and Safety code. LPA observed the gate was locked with an automatic latch mechanism. There are no firearms/weapons stored in the facility. Continue on LIC809C.... Continued from LIC809.... LPA reviewed facility records to ensure staff have received required training and criminal record clearances. LPA also determined there were no excluded personnel employed by the facility. All staff are properly associated to the facility with current first aid certification. First aid kit was available and contained the necessary items. LPA also reviewed client files to determine if residents have medical assessments on file. All client files contain required documents and are current. William Lee is the certified administrator for the facility and certificate is valid through 2/14/2025. LPA observed required postings throughout the facility. Drills are conducted quarterly and the last drill was 9/1/2023. Fire extinguishers and smoke alarms were observed to be operable. LPA reviewed medications and the following deficiencies were observed: - medications were stored in a locked cabinet in the kitchen, however medications were pre-prepared in medication cups. LPA informed Administrator medication is to be always stored and dispensed from its original container. -LPA reviewed medication log and observed that morning medications were given but not initialed/recorded by staff in the medication log. LPA was informed staff usually log medications given later in the day. LPA informed Administrator medications dispensed are required to be logged and signed off by staff at the time it is given. An exit interview was conducted. A copy of this report along with a LIC809D and copy of Appeal Rights was provided to Administrator, William Lee.