Routine inspection·October 10, 2023

On October 10, 2023 Licensing Program Analyst(LPA) Murial Han conducted an unannounced annual inspection. LPA was greeted by caregivers, Rhealynne Cabarlez and Phillip Elera and LPA explained the purpose of the visit. Caregiver Rhealynne contacted the administrator via phone of LPA's visit and administrator arrived shortly thereafter and assisted with the inspection. LPAs toured the facility inside and outside including the bedrooms (4 private rooms, 1 semi-private room and 1 staff room), 2 full- bathrooms, kitchen, and common areas. The facility observed to clean, tidy and in good repair. Bedrooms were equipped with the required furniture for residents to use. Bathrooms are equipped with grab bars, and nonskid mats. Facility temperature is comfortable. Hot water temperature was measured at 102- 105 degrees F. Central stored medication were observed to be locked and inaccessible to residents. Food supplies were observed to be adequate, At 11:08 am, LPA observed toxins and sharps objects in the kitchen were unlocked. LPA reviewed 3 staff training records and observed 2 out of 3 were adequate, and staff #1(S1) was missing some records. According to administrator that S1 has completed all the required training but some of the records are kept at the administrator's residence. Facility is equipped with smoke detectors and carbon monoxide detectors. Fire extinguisher was last serviced Oct 13, 2022. Fire drill was last conducted on August 2023. Staff members at the facility were fingerprint cleared and associated to the facility. LPA reviewed residents and staff records. Resident records contained admission agreement, medical assessment, LIC 602 (Physician Order), Appraisal Needs and Service Plan, GGRC/IPP, etc. Staff files contained personnel records, health screening, COVID-19 vaccination card, Abuse Statement, First Aide and CPR, Criminal Record Statement. LPA reviewed P & I records and observed Record of Client's/ Resident's Safeguarded Case Resources (LIC 405) and receipts for 3 residents. During today's inspection, there were 2 residents present and 2 were attending the adult day program. Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. This report is reviewed and discussed with caregiver, Phillip Elera. A copy of this report and Appeal Rights were provided.