Routine inspection·February 13, 2024

On February 13, 2024, Licensing Program Analyst(LPA) John Calandra arrived at the facility at 11:54 AM to conduct an unannounced Annual 1-year required inspection. LPA Calandra met with Jason Pineda, Administrator and explained the purpose of his visit. LPA Calandra toured the physical plant. This is a two story building that consists of 6 bedrooms and 3 bathrooms. Water in all bathrooms was measured within the required range of 105-120 degrees Fahrenheit. Bathrooms were observed to have the required grab bars and anti-skid mats. Fire extinguishers in the facility were observed to be fully charged and last checked on October 30, 2023. The facility had the required 7 days of non-perishables and 2 days of perishables on site. No food was expired. The kitchen refrigerators and freezers temperature was within the required range. All bedrooms were sufficiently lit and had the required furniture. The backyard was 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. The facility was maintained at a comfortable temperature of 70 degrees Fahrenheit. 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 also reviewed 5 resident and 5 staff files. All were observed to be complete. During today's visit, Type B violations were issued for the facility administrator failing to provide both a Fire Safety Plan (HSC 87212(b)(2)(a)-Emergency Disaster Plan) and Evacuation Procedures, including identification of an assembly point or points that shall be included in the facility sketch.(HSC 1569.695) 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. This report was reviewed with Administrator, Jason Pineda and a copy along with appeal rights left at the facility.