Routine inspection·May 9, 2023

Licensing Program Analyst (LPA) Renee Campbell conducted an unannounced Annual 1-Year required visit on this date. LPA met and toured with Juanito De La Cruz the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 4 total bedrooms of which 3 bedrooms are occupied by the residents and 1 bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 70 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 120 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars. 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 visit. Fire extinguisher was last serviced on December 19, 2022. Emergency Disaster Plan was last posted on 04/13/2022. First aid kit was observed to be complete. Fire drill was last conducted on March 11, 2023. All staff present were cleared and are associated to the facility. Based on prior deficiencies for the facility, LPA inspected all client medications and MAR, ensured dangerous items were secured and checked for the presence of expired food and other potential hazards. LPA Campbell reviewed 3 of 3 residents’ files.. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 ,and California Health and Safety Code. Failure to correct deficiencies may result in civil penalties. Exit interview conducted. Appeal Rights and a copy of this report provided .