Routine inspection·November 8, 2024

On November 8, 2024, Licensing Program Analyst(LPA) John Calandra arrived at the facility at 10:30 AM to conduct the Annual 1-year required inspection. LPA Calandra was greeted by William Bautista, Caregiver and explained the purpose of the visit. Evelyn Ryan, Administrator was unavailable to join the visit. Corazon Medina, Lead Staff and Elenita "Ruby" Cruz, Caretaker joined the visit later. LPA Calandra toured the physical plant. This is a 2-story building with 6 bedrooms, 3 bathrooms, a living room, dining room, kitchen, front and back yards, and staff room. All bedrooms had the required furniture and sufficient lighting. No accessible bodies of water or hazards were observed in hallways or the front and back yards. The facility was kept at a comfortable temperature. The hot water temperature was within the required 105-120 degrees Fahrenheit. The facility had the required 7 days of non perishables and 2 days of perishables on site. No food was expired. All sharp objects were locked and in-accessible to persons in care. All soap, detergent, and poisons were observed to be unlocked and accessible to persons in care but were locked in the presence of the LPA. LPA Calandra reviewed 5 staff files. All were observed to be mostly complete but missing certain documentation related to training and CPR/First Aid Certification. A review of Centrally Stored Medications indicated that medications for residents were properly labeled with instructions on dosage and times of day and matched the Centrally Stored Medication Records(CSMR) kept at the facility. All Personal and Incidental (P & I) monies kept at the facility matched the records stored at the facility. During the visit, the following documents were collected: - Current Liability Insurance The facility will send the current LIC 500 and Surety Bond to the Regional Office (RO) by 11/22/2024. ********************************************This is an AMENDED Report************************************************** During the visit, LPA Calandra noticed through record review that S1 has fingerprint clearance but is not currently associated to the facility per review of Guardian (Finger print/Criminal Record Clearance system). Per interview with S1, LPA learned that S1 assists clients/persons in care with activities of daily living such as bathing, dressing, etc. The facility was assessed a Civil Penalty of $500 ($100 a day x 5 days) because S1 has been working at the facility from 10/3/2024 to 11/8/2024 without being associated to the facility. The deficiencies are cited under the California Code of Regulations, Title 22. Failure to correct the deficiencies by the due date may result in civil penalties. The Annual inspection will be completed at a later date. An exit interview was conducted. This report was reviewed with Corazon Medina, Lead Staff and a copy of the report along with appeal rights left at the facility.