Routine inspection·May 1, 2023

Licensing Program Analyst (LPA) Renee Campbell conducted an unannounced Annual 1-Year Required visit on this date. LPA met and toured with Administrator, Priscilla Quitevis. The administrator currently holds a certificate (#6009772740) that expires on 10/14/2023 LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 16 total bedrooms of which 14 bedrooms are occupied by the residents and 2 bedrooms are occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 70 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 108 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars. There is a minimum of 7-day supply of nonperishable and 2-day of perishable foods. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 01/05/2023. Three of five fire extinguishers were out of date. Administrator will purchase new ones within 24 hrs. First aid kit was observed to be complete. LPA reviewed 3 of 8 staff record files and the facility has sufficient staffing to provide the services needed to meet the residents’ needs . One staff member did not have a negative TB test on file . The facility serves residents with mental illness and staff have received the necessary training hours specific to mental illness. LPA reviewed 3 of 23 residents’ files. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 05/05/2023:. LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report Liability Insurance The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 ,and California Health and Safety Code. Failure to correct deficiencies may result in civil penalties. Exit interview conducted. Appeal Rights and a copy of this report provided.