Routine inspection·May 21, 2024

Licensing Program Analyst (LPA) Ruth Wallace conducted an unannounced Required 1 Year Inspection Visit. LPA met with administrator and explained the purpose of the visit. Administrator Certificate expires 10/26/2025. LPA and administrator toured the physical plant including resident bedrooms, resident bathrooms, and property area. LPA observed the facility to be free of odor, clean and in good repair. LPA observed sufficient furniture and lighting throughout the facility. There are no bodies of water present. LPA observed sufficient seven day non-perishable and two day perishable food supplies. Hot water temperature was measured at 111.9 degrees Fahrenheit in kitchen sink, which is within the required regulation of 105 to 120 degrees Fahrenheit. Fire extinguishers last inspected 4/1/2024. LPA checked medication storage and found medication to be locked away and inaccessible to residents. First aid kit was checked and is complete. Emergency and disaster drill conducted on 5/1/2024. LPA reviewed four resident files and three staff files, including criminal record clearances. A review of staff records indicates that all staff or other individuals who require caregiver background checks are Fingerprint cleared and but staff 2-3 are not associated or transferred to the facility. Licensee will have staff get fingerprint cleared today and send documentation to LPA Wallace when cleared. LPA verified staff training for staff file reviews. LPA requested the following updated documents for community care licensing to be submitted via email by May 28, 2024: LIC 308 Designation of Administrator, LIC 500 - Personnel Report, Copy of Administrator's Certificate, and Copy of Liability Insurance with expiration date. ruth.wallace@dss.ca.gov Based on today’s visit, Per California Code of Regulations, Title 22 Division 6, Chapter 8, see 809-D for deficiency observed or cited today. Immediate civil penalty issued on today's date for both staff. Failure to correct deficiency may result in the additional civil penalties. Exit interview conducted with administrator. A copy of report and LIC 811 (Confidential Names) left at facility.