Routine inspection·September 26, 2024

Licensing Program Analyst (LPA) Renee Campbell arrived at the facility to conduct an unannounced annual inspection on 09/26/2024.  LPA Campbell met with Sharon Fernandez, House Manager and Administrator and explained the purpose of the visit. LPA Campbell inspected the physical plant including but not limited to the common area, kitchen, dining area, client bedrooms, client bathrooms, laundry room and the backyard of the facility to ensure compliance with Title 22 regulations . This facility is a single story building licensed to serve six (6) ambulatory residents and there is a hospice waiver for three (3). LPA Campbell observed the facility to be free of odor, clean and in good repair. LPA Campbell observed bedrooms to be properly furnished with appropriate bedding and lighting. There are no bodies of water present . LPA Campbell observed sufficient seven-day non-perishable and two-day perishable food supplies. The hot water temperature was measured in the kitchen and bathroom. The kitchen water temperature measured at 109.6 degrees and the resident bathroom water temperature measured at 109.4 degrees. Fire extinguishers, smoke and carbon monoxide detectors are in good repair. The fire extinguisher was last inspected on 07/25/2024. The facility thermostat was observed at 73 degrees Fahrenheit. LPAs checked medication storage and found medication to be locked away and inaccessible to clients in a kitchen pantry. The First aid kit was incomplete and was missing a tweezer that was provided during the visit. LPA Campbell re quested client and staff files for review. LPA Campbell reviewed 4 of 4 resident files and 4 of 10 staff file s . Of the 4 files reviewed, 2 of them were missing Personal Rights documentation. Staff files were complete. Toxins were made inaccessible to clients in care. Toxins were stored in a locked cabinet in the laundry room. The following documents will be email to LPA Campbell ( Renee.Campbell@dss.ca.gov ) by 09/30/2024 by 5:00 PM by end of day: (1) LIC 308 Designation of Administrative Responsibility (2) LIC 500 Personnel Report (3) Copy of Administrator Certificate  (once the new one is received by Administrator) (4) LIC 610 Emergency Disaster Plan (5) LIC 9282 Infection Control Plan Per California Code of Regulations, Based on today's inspection, per the California Code of Regulations, Title 22, Division 6, Chapter 8, deficiencies were observed or cited and noted on LIC 809D. Note that failure to correct any deficiencies will result in additional civil penalties. An exit interview was conducted and a copy of this report was left with the facility.