Routine inspection·September 11, 2024

On September 11, 2024, Licensing Program Analysts(LPAs) John Calandra and Yi Sam Jian arrived at the facility at 12:05 PM to complete the Annual 1-year required Inspection. LPAs Calandra and Jian were greeted by Luong "Jack" Ly, Administrator and explained the purpose of the visit. LPAs toured the physical plant. This is a 2 story building with 8 bedrooms and 3 bathrooms, backyard, kitchen, living room, dining room, garage/office, and laundry room. No accessible bodies of water or hazards were observed. The facility's fire extinguishers were last checked on 6/18/2024 and were fully charged. Bedrooms were sufficiently lit and had the required furniture. The facility's first aid kit had the required items. The facility had the required 7 days of non perishables and 2 days of perishables on site. No food was expired. The facility was maintained at a comfortable temperature. All sharp objects, poisons, chemicals, and soap were locked and in-accessible to persons in care. One can of body soap and handwashing soap were removed and locked in the presence of the LPAs. LPAs reviewed 5 resident files and 6 staff files. All staff files were observed to be complete but 4 out of 5 resident files were missing the Annual Needs and Services Plan. A Technical Violation was provided for not having 4 resident Annual Needs and Services Plans. A Type A Violation was provided for restricting a resident's movement while in bed. A review of Centrally stored medications indicated that medications for residents were properly labeled with instructions on dosage and times of day and matched the Centrally Stored Medication Records(CSMR) kept at the facility. Deficiencies are cited under California Code of Regulations, Title 22, cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. An Exit interview was conducted. This report was reviewed with Luong "Jack" Ly, Administrator and a copy of the report along with Appeal Rights left at the facility.