Routine inspection·April 24, 2025

Licensing Program Analyst (LPA) Yolanda Delgado arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry. LPA began inspection with introduction, visit purpose and provided the facility with LPA identification and business card. Resident record review began- Ten (10) records were reviewed. LPA reviewed for admission agreement, medical assessment and TB test results, consent forms, identification and emergency information, appraisal needs and service plans, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. This facility is meeting documentation requirements. Employee records review began- Six (6) records were reviewed. LPA reviewed employee record for first aid certification, fingerprint clearance, personnel/job application, health screening and TB test results, criminal record statement, employee rights, training verification, and current administrator certification. CPR and requirements have been met. The facility employs enough staff to maintain cleanliness and meet the needs of the clients in care. Administrator certification is present and renewed on 2/26/2025 and still processing. Physical Plant and Safety of Environment/Operational Requirements- LPA toured the facility inside and outside. The buildings are maintained at a comfortable temperature for the clients. Lighting is sufficient for safety and comfort. Water temperature measured 110.0 degrees F. Laundry is done in the designated laundry room located on the 2 nd floor of building B. There is a locked closet for storing laundry soap and other chemicals in the housekeeper’s closet on the 2 nd floor All outdoor and indoor passageways are free of obstruction. (Continued on next page) Continued on from Page 1) There is a location for sharps in the kitchen. LPA verified there is a telephone working at this location. There are no firearms stored and no bodies of water observed. Infection Control: The LPA observed the hand washing stations in the facility restrooms and kitchen had hand hygiene supplies and hand washing signs. LPA observed PPE equipment and cleaning supplies to do regular cleaning of the facility. LPA reviewed the facility's infection control plan which met department requirements. LPA reviewed staff records and found that all staff had infection control training. Food Service- Food supply meets the requirement of one week supply of nonperishable and 2-day supply of perishables food on hand. A menu is posted, foods are dated to assure safety. Food prep areas are clean and organized. LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. The facility has not exceeded its capacity limitation, and the structure remains unchanged according to the approved floor plan. Smoke detectors and carbon monoxide detectors are tested quarterly 2/12/2025 for ten (10) buildings and LPA observed report from Dialcom Systems Group Inc. were tested and found to be operational. Fire extinguishers are tested or replaced annually and were last done so on 1/6/2025. The facility is conducting emergency disaster drills monthly. The last disaster drill was conducted on 03/28/2025. Based on the information received during this visit today, there are no deficiency that is being cited per Title 22, Division 6 of The California Code of Regulations. This report was reviewed with Diane Domingo and a copy provided at the time of the exit interview.