Routine inspection·January 5, 2024

On January 5, 2024, Licensing Program Analyst(LPA) John Calandra arrived at the facility at 9:06 AM to conduct an unannounced Annual 1-year required inspection. LPA Calandra met with Rodella Pasamonte and Jude Torres, Caregivers. Administrator, Maribel Cayco joined later in the visit. LPA Calandra toured the physical plant. This is a two story building that consists of 5 bedrooms(4 for residents and 1 staff bedroom) and 2 bathrooms. Water in all bathrooms was measured between the required 105-120 degrees Fahrenheit. Bathrooms were observed to have the required grab bars and anti-skid mats. Fire extinguisher in the facility was observed to be fully charged. The facility had the required 7 days of non-perishables and 2 days of perishables on site. No food was expired. The kitchen and garage refrigerators and freezers temperature were within the required range. All bedrooms were sufficiently lit and had the required furniture. The front and backyards were clear from obstructions. No accessible bodies of water or hazards were observed. The facility's first aid was observed to be complete. The facility does not handle any cash resources. There were 3 staff and 4 residents present during the inspection. All knives and sharp objects were observed to be locked and in-accessible to persons in care. All medications, soaps, and detergents were observed to be locked and in-accessible to persons in care. 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 kept at the facility. LPA Calandra reviewed 5 resident records. Four of the records did not contain a Needs and Services Plan and one did not have an LIC 602: Physician's Report. LPA also reviewed 3 resident records. All were observed to be complete. LPA interviewed 2 residents and 2 staff. Deficiencies of the California Code of Regulations, Title 22 are cited on the LIC 809-D. Failure to correct the deficiencies may result in civil penalties. A copy of the Report, Citation, and Technical Violation was reviewed with Administrator/Licensee, Mirabel Cayco and left at the facility. Appeal rights were provided.