Routine inspection·July 3, 2024

On 07/03/24, Licensing Program Analyst (LPA), Javina George made an unannounced visit to the facility to conduct the required annual inspection. LPA met with Caregiver Clarizza Bawiin and Administrator, Kevin Calhoun via telephone as he was unable to come to the facility. LPA explained the purpose of the visit. At the time of the visit there were 2 staff and 5 residents present. The home is licensed to serve age range 60 and over, 6 non-ambulatory of which 6 may be bedridden. The facility has an approved hospice waiver for 4. There are currently 3 residents receiving hospice services. The facility was observed to be clean, clutter and odor free. Outdoor and indoor passageways are free of obstruction. The facility is a single story consisting of (5) bedrooms, and (3) bathrooms, kitchen, living room, backyard, and garage. The restrooms were equipped with grab bars and non skid mats. The facility food supply met the requirements as there is a 7 day supply of non perishables, and a 2 day supply of perishable food items. The fire extinguisher was observed to be fully charged, with tag in tact. Carbon monoxide and smoke detectors were tested and were observed to be operable. The facility was observed to have the required postings such as Emergency disaster plans, personal rights, and complaint procedures were posted in a prominent area. LPA conducted a records review of 5 resident and 4 staff files. The files were found to have the required documentation, staff were observed to have obtained criminal record clearance. Per the records review 2 of 2 staff did not possess a valid CPR certification. A citation will be issued in accordance with the California Code of Regulations (Title 22, Division 6, Chapter 8), on the attached 809D. An exit interview was conducted and a copy of this report, appeal rights and LIC9098-Proof of Corrections form was reviewed and provided to the Clarizza Bawiin, Caregiver.