Routine inspection·May 1, 2025

On 5/1/2025, Licensing Program Analyst (LPA) Tobola conducted an unannounced Annual Required – 1 yr. inspection for this facility and was greeted by House Manager/Caregiver, Anica Koljenik. Administrator, Fatmata Bangura was contacted and arrived later in the visit. The facility currently provides care for 6 residents 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 and carbon monoxide detectors were present. Emergency disaster plan is reviewed and completed. Disaster drills are conducted on a quarterly basis. 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. There is a large outdoor patio equipped with appropriate shading for resident use. Medications are stored in the living room 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 and physician's reports in need of updating. Upon a sample review of staff files LPA found that all caregiver staff have current 1st aid and CPR certification on file. LPA discussed with Administrator staff training requirements. Administrator has attempted to contact approved vendor trainers. LPA provided technical support. Technical Advisory issued. Administrator agrees to provide update of completed annual training for staff. LPA requested the following documents be sent to CCL by COB 5/15/2025: 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.