Routine inspection·November 17, 2022

On 11/17/22 at 2:20pm Licensing Program Analyst (LPA) Maja Jensen arrived at facility unannounced to conduct a required 1 year annual visit. LPA Jensen met with Licensee Angelique Morrow and explained the purpose of today's visit. LPA Jensen toured the grounds and the physical plant. The grounds were observed to be well maintained and all pathways are free of obstruction. There are no bodies of water on the property. The interior of the physical plant was observed to be sanitary and free of odor. The facility has a single designated entrance with everything necessary for COVID screening. All required signs were posted in prominent areas. There was adequate lighting observed and adequate furniture observed. There are 4 resident bedrooms and 2 of 4 bedrooms are double occupancy. The resident bedrooms all were observed to contain a lamp, dresser, night stand and chair. There was an adequate supply of linen observed. All medications, toxins, and sharp objects were observed to be locked and inaccessible to residents in care. LPA Jensen observed a 2 day supply of perishable food and 7 day supply of non-perishable food on hand. The facility also maintains a 30 day supply of PPE on site. The water temperature in the resident bathroom in the main hallway was measured at 112.5 degrees which falls within the required regulatory range of 105 - 120 degrees. The thermostat was set at 74 degrees which falls within teh required regulatory range of 68 to 85 degrees. The fire extinguishers were serviced on 11/17/22 and are in compliance. The fire alarm and carbon monoxide detectors were tested and found to be in good in repair. The first aid kit was observed to be complete with tweezers, scissors, a thermometer, manual and various wound dressings. Two staff files were observed and found to be complete. 3 of 6 resident Medication Administration Records were compared against actual medications and were found to be compliant. All required signs were posted in prominent locations. Continued on LIC 809C... LPA Jensen requested the following be sent via email to maja.jensen@dss.ca.gov by 11/22/22 LIC 500 LIC 308 Liability Insurance upon renewal in December of 2022 The facility was observed to be in substantial compliance. No deficiencies were issued as a result of this visit. An exit interview was conducted and a copy of this report was given to Licensee Angelique Morrow.