Routine inspection·February 26, 2025

On 2/26/2025, Licensing Program Analyst (LPA) Tobola conducted an unannounced Annual Required – 1 yr. inspection for this facility and was greeted by Administrator, Margie Valeria. The facility currently provides care for 10 residents, 1 resident who is receiving hospice services and some of which with a diagnosis of dementia. LPA continued with a tour of the facility with staff, facility found to be clean and at a comfortable temperature with all exits free from obstruction. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguishers located throughout the facility were found to be charged. Smoke detectors and sprinkler systems were present in each common room and resident bedroom with last fire safety inspection conducted in March 2024 ensuring all fire safety systems are in place. There is a designated closet for cleaning supplies, however, LPA requested Administrator to change garage doorknob to a lockable system in case of any items stored in the garage that could pose safety risk. Technical Assistance provided. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations, with food stored in the kitchen refrigerator found to have appropriate coverings, enough for residents in care. Cleaning supplies and other toxins are safely stored upon inspection. There was a supply of hygiene products and paper products available for residents. Resident's bedroom have lighting & appropriate furnishings and bedding items. Restrooms for resident use were equipped with non-slip mats, grab bars and kept in good condition. Upon spot review of medications, LPA found that the facility has documentation of resident prescriptions on file with medication counts in order. Continued onto LIC809-C LPA conducted a sample file review for residents and found that 2 residents' (R1,R2) pre-appraisal assessments were not conducted prior to admission. Both residents were recently admitted and Administrator agrees to complete assessment for resident care needs. Upon a sample review of 5 staff files LPA found that all caregiver staff have current 1st aid and CPR and training on file. Administrator, Margie Valeria's Administrator Certificate 7015084740 is valid through 2/22/2026 LPA requested the following updated documents be sent to CCL by COB 3/12/2024: LIC 308 Designated Facility Responsibility LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan Deficiency cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12-month period may result in civil penalties.