Routine inspection·October 29, 2021

Licensing Program Analyst (LPA) Albert Johnson arrived unannounced to conduct an annual inspection. LPA met with Administrator Nora Remolona Administrator holds current certificate that expires 11/01/2022. LPA and Staff inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, activity room, and outside courtyards. LPA observed sufficient furniture and lighting throughout the facility. LPA observed sufficient seven day non-perishable and two day perishable food supplies. Hot water temperature was measured at 130.5 degrees Fahrenheit in resident bathroom sink of the left side of the building, which is not within the required range of 105 to 120 degrees, right side of the building resident bathroom hot water temperature was measured at 108.5 degrees Fahrenheit, which is within the required range of 105 to 120 degrees. Last fire drill was conducted on 08/17/2021. Fire extinguishers and smoke detectors are current and in compliance with fire safety. LPA reviewed and compared resident medication vs. resident medication logs. LPA reviewed 5 resident's files, LPA identified 5 residents on hospice this was confirmed by Administrator. LPA reviewed 3 staff files including criminal record clearances. All staff are fingerprint cleared and associated to the facility. First aid kit was checked and is complete The following deficiencies were observed and cited on the following LIC 809-D pursuant to Title 22 rules and regulations, Health and Safety Codes. Exit interview conducted and appeal rights discussed .