Routine inspection·March 6, 2025

On 3/6/2025, Licensing Program Analyst (LPA) Tobola conducted an unannounced Annual Required – 1 yr. inspection for this facility and was greeted by Lea Pantango and Caregiver Julio Yap. The facility currently provides care for 9 residents some of which with a diagnosis of demen tia. 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 were present in each common room and resident bedroom. Carbon monoxide detector located in hallways were tested an in working order. Emergency disaster plan is reviewed and completed. 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. 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. During inspection, LPA observed container of powder bleach in resident restroom not kept in secured storage. Staff immediately removed the cleaning supply and stored properly. There is a large outdoor patio equipped with appropriate shading for resident use. Medications are stored in the kitchen and found to be secured. Upon spot review of medications, LPA found that the facility has centrally store medication records updated and in order. LPA conducted a sample file review for residents and found 3 resident appraisals not signed or completed. Upon a sample review of staff files LPA found that all caregiver staff have current 1st aid and CPR certification, annual training, health screening reports on file. LPA requested the following documents be sent to CCL by COB 3/20/2024: 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.