Routine inspection·April 6, 2022

On 04/06/2022 at 9:55 AM, Licensing Program Analysts (LPAs) T. White and R. Campbell arrived unannounced to conduct a required 1-year annual inspection. LPAs met with Caregiver Juanito De La Cruz and explained the purpose of today’s inspection. LPAs were allowed entry into the facility that is licensed to serve a total capacity of 6 residents, of which 2 may be non-ambulatory. LPAs toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. A comfortable temperature is maintained at 73 degrees Fahrenheit. Hot water temperature measured at 115.3 degrees F. LPAs observed lighting in all rooms are adequate for the comfort and safety of the residents. There is a minimum of a 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 December 23, 2021. First aid kit was observed to be complete. LPAs reviewed 3 resident files and 1 staff record file. LPAs observed the following deficiencies: - LPA's observed expired food on top of the kitchen island. - LPAs observed unlocked medications in the kitchen cabinet. - LPAs observed expired medications not disposed correctly. - LPA's observed unwrapped meat in the freezer. Report continues on 809C. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 04/15/2022: LIC 308 Designation of Administrative Responsibility LIC 500 Personnel Report LIC 610E Emergency Disaster Plan The following deficiencies was observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct deficiencies may result in civil penalties. Exit interview conducted with Caregiver. A copy of report and Appeal Rights given.