Routine inspection·October 16, 2023

Licensing Program Analyst (LPA) Ruth Wallace conducted unannounced Required 1 Year Annual Inspection Visit. LPA met with the administrator and explained the purpose of the visit. LPA and administrator inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, living area, common TV area, and outside backyard of the facility to ensure compliance with Title 22 regulations. There are four bedrooms total in this facility. No obstructions to fire exits noted. Facility has a separate living room and family room with dining area off the kitchen. The facility submitted a LIC 808 mitigation plan, which was approved. Water temperature reads 109.8*F in the kitchen sink which meets the 105-120 degree Fahrenheit regulation. and room temperature reads 75.2*F. LPA observed the facility to have adequate food supply. Resident rooms were sanitary and had the required furniture and furnishings. The facility common areas were clean and furnished. Smoke and carbon detectors were in good repair. Fire extinguishers were last inspected on May 16, 2023. Facility has an emergency food and water kit. LPA reviewed three staff and five resident files that were locked and readily available for review. Staff had current First Aid/CPR certificates All staff have criminal record clearance and are associated to the facility. LPA requested the following updated documents to be submitted via email by 10/23/2023: LIC 308 Designation of Responsibility and copy of liability insurance. ruth.wallace@dss.ca.gov Per the California Code of Regulations, Title 22 no deficiencies were observed or cited. Exit interview held with Administrator. A report and LIC 811 (Confidential Names) was left at the facility