Routine inspection·October 6, 2023

Licensing Program Analyst (LPA) Jacqueline Shaw Ross made an unannounced visit to the facility for the purpose of an annual review. LPA was greeted by Felipa Arango, Caregiver and explained the purpose of the visit. Administrator Elizabeth Rivera joined shortly. A tour of the facility was conducted inside and out. At the time of visit, all six (6) residents were home and two (2) staff were present. The facility is approved for six (6) elderly residents ages 60 and over, non-ambulatory, of which 1 may be bedridden. There is a hospice waiver for six (6) residents. The facility is a six (6) bedroom three (3) bathroom one story home. Four (4) bedrooms are private, one (1) bedroom is shared, two to a room. One bedroom is reserved for overnight staff. During the tour the following was observed: Resident bedrooms had the required furnishings and were observed to be in good condition. Bathrooms had required signage, hand rails, non-slip mats. Night-lights were observed in the hallways. Fixtures and furniture for an operational facility are present and in good repair. All passageways were free of obstructions, charged fire extinguishers and the fire alarm system was operable, medications are kept centralized and locked, hazardous items are kept inaccessible to residents. Hot water was tested at 115 degrees Fahrenheit. The backyard area is free of obstructions. Kitchen/Food Service: LPA observed the entire kitchen, food is stored properly and dishes are clean and in good condition. There is a sufficient supply of perishable and non-perishable foods. Area was observed to be clean and functional. Care & Supervision : Facility has sufficient care staff employed. Administration: Emergency exiting plans, telephone numbers and Ombudsman information and other required signage are posted throughout the facility. Drills are conducted quarterly. The last drill was 9/30/2023. Record Review and Client/Staff Files: LPA reviewed current staff and all staff have has Criminal Background Clearance, current CPR/First Aid certification, and trainings are current. Client records were reviewed and all contain required documents and are up to date. Medication Review: LPA reviewed medication and medication log. Residents' medications are being dispensed according to physician's orders. No deficiencies were cited per Title 22, Division 6 of the California Code of Regulations at this time. An exit interview was conducted and a copy of this report was provided to Elizabeth Rivera, Administrator