Routine inspection·May 14, 2021

On 05/14/2021 at 8:20am, Licensing Program Analyst (LPA) T. White spoke with Licensee, Corazon Poier regarding facility risk assessment questions. Licensee confirmed no staff or clients have experienced symptoms within the last 10 days. At 9:45am, LPA T. White arrived unannounced to conduct a required 1-year annual inspection. LPA met with Licensee and explained the purpose of today’s inspection. LPA was allowed entry into the facility that is licensed to serve a total capacity of 6 residents. LPA 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. A comfortable temperature is maintained at 75 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 110 degrees Fahrenheit. There is a minimum of 7-day supply of nonperishable and 2-day of perishable foods. Smoke detectors and carbon monoxide were in operating condition during inspection. Fire extinguisher was last serviced on February 17, 2021. Emergency Disaster Plan was last posted on 10/14/2020. First aid kit was observed to be complete. Fire drill was last conducted on 05/05/2021. LPA reviewed mitigation plan with Administrator. - On 05/14/202, LPA T. White observed three medication bottles ( Losaratan, Meditone, Aspirin) in the unlocked kitchen drawer accessible to residents in care. Report continues on 809C. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 05/21/2021: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan The following deficiency was observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct deficiency may result in civil penalties. LPA had printer issues and will submit report and appeal rights via email. Exit interview conducted with Administrator.