Routine inspection·January 9, 2023

Licensing Program Analyst (LPA) Ruth Wallace conducted unannounced Required 1 Year Annual Inspection Visit. LPA met with administrator and explained the purpose of today’s inspection. LPA was allowed entry into the facility after getting temperature checked and COVID-19 precautions. Facility is licensed to serve a total capacity of six non-ambulatory residents, currently there are four residents. LPA and administrator toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature for residents is maintained at 72 degree Fahrenheit. The hot water temperature was observed to be 109.7 degrees Fahrenheit, which is within the required regulation of 105 to 120 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. All toilets, hand washing, and bathing are safe, sanitary and in operating condition. There is a minimum of 7 day non-perishables and 2 day perishables foods. LPA observed smoke detectors are interconnected with the fire department. Carbon monoxide is in operating condition. Fire extinguishers were last serviced on 2/7/2022. LPA observed mitigation plan completed. First aid kit observed to be complete. Fire drill was last conducted on 12/17/2022. LPA reviewed three (3) staff records and two (2) resident records. All files were complete. Staff are fingerprint cleared and first aid certified. Liability Insurance expires 3/1/2023. LPA observed medications and the MARS sheets. Medications appear to be documented appropriately. LPA received the following updated documents on January 9, 2023: Administrator Certificate, Articles of Incorporation, Liability Insurance, LIC 308 - Designation of Administrative Responsibility, and LIC 610-E Emergency Disaster Plan. Per the California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies observed or cited. Exit interview conducted with administrator and a copy of report given.