Follow-up·December 12, 2023

Licensing Program Analyst (LPA) Ruth Wallace arrived unannounced to conduct a case management visit. LPA met with Licensee/Administrator. Administrator holds current Administrator's certificate # 6061970740 which expires March 13, 2024. LPA and Licensee toured the physical plant and grounds. The grounds were observed to be maintained and outdoor furniture in a shaded area is available for resident use. The facility currently has four residents in care. LPA inspected the bedrooms, bathrooms, kitchen, staff quarters and common areas. The thermostat was set at 74 degrees for the comfort of residents in care. Knives, toxins, cleaning supplies were observed to be locked and inaccessible to residents in care. There are currently three bedrooms in use, one room has double occupancy. The other two rooms are private occupancy. The bathrooms were equipped with grab bars in the shower and at the toilet. The water temperature in the main bathroom adjacent to the common area was measured at 110.3 degrees which falls within the required regulatory range of 105-120 degrees Fahrenheit. The facility maintains a two day supply of perishable food and a seven day supply of non-perishable food. There is also an adequate supply of linens. The fire extinguisher was last serviced on April 6, 2023 and is in compliance. The carbon monoxide detector was tested and found to be in working order. The first aid kit was observed to be complete with scissors, tweezers, thermometer, various wound dressings and manual. LPA reviewed three resident files and three staff files. All resident and staff files were determined to be complete and in compliance. Medication Management including destruction of Medication and PRN’s was reviewed. All records in compliance. No deficiencies are being cited from the California Code of Regulations Title 22, Division 6. An exit interview was conducted with licensee. A copy of this report and LIC 811 (Confidential Names).