Routine inspection·February 6, 2024

Licensing Program Analyst (LPA) Ruth Wallace conducted unannounced required 1 year annual inspection visit. LPA met with Administrator and explained purpose of visit. Administrator Certificate expires 8/15/2024. LPA and administrator inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, and outside backyard. LPA observed sufficient furniture and lighting throughout the facility. LPA observed sufficient seven day non-perishable and two day perishable food supplies. LPA measured the hot water temperature in resident's bathroom at 110.3 degrees Fahrenheit which is within the required range of 105 to 120 degrees. Fire extinguishers last inspected on 1/8/2024. Smoke detectors are operational. LPA observed centrally stored medications are kept locked and inaccessible to residents. LPA reviewed and compared resident medication vs. medication logs. First aid kit was checked and is complete. LPA observed carbon monoxide detectors in the facility. The facility conducts fire/disaster drills with residents on 9/2/2023, therefore facility is not in compliance. A facility shall conduct a drill at least quarterly for each shift. LPA reviewed five resident files and five staff files, including criminal record clearances. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks are Fingerprint cleared and associated to the facility. LPA verified staff training for staff file reviews. LPA requested the following updated documents to be submitted via email to community care licensing by February 13, 2024: LIC 308 Designation of Administrator, LIC 500 - Personnel Report, Copy of Administrator's Certificate, and Copy of Liability Insurance. ruth.wallace@dss.ca.gov Per the California Code of Regulations, Title 22, Division 6, Chapter 6, see 809-D for deficiency cited during this visit. Immediate civil penalty issued of $500.00. Failure to correct the deficiency may result in additional civil penalties. Exit interview held with administrator. A copy of reports, civil penalty, appeal rights, and LIC 811 (Confidential Names) were left at facility.