Routine inspection·April 29, 2024

LPA Audrey Jeung toured facility and grounds, consisting of 6 client bedrooms and 2 staff bedrooms--all with half bathrooms--full bath/shower room, living/dining area, kitchen, recreation room. There are two beds in each staff room. Washer and dryer are located in attached garage, which also accesses stairs to upper level storage rooms. An accessory dwelling unit (ADU) is being built in backyard. No accessible bodies of water or fire safety hazards observed. PPE supply is adequate. Medications, toxins and sharps are stored appropriately and inaccessible to clients, a comfortable temperature is maintained, and lighting is sufficient for comfort and safety. Toilet and bathing facilities are equipped with grab bars and nonskid flooring material. Liquid soap is available at all sinks. First-aid kit is inspected and complete. A Disaster and Mass Casualty Plan is posted. There are 6 residents present, and 2 staff. Criminal record clearances or exemptions for facility staff or other individuals who have client contact have been reviewed, as well as staff records. Judy Roias, Michelle Roias, and Mercy Moreira are certified RCFE administrators (x 5/25, 5/25, 12/24) that oversee facility operations. Client records are reviewed, including hospice care plans for 3 residents. The following updated forms/information are requested to be submitted to CCLD BY 5/13/24: • LIC 308 Designation of Administrative Responsibility • LIC 500 Personnel Report • LIC 610E Emergency Disaster Plan (page 9 signed and dated) • Building Permit for ADU - Revised sketch of facility grounds (including ADU) Deficiency of the RCFE California Code of Regulations, Title 22, Division 6, Chapter 8 is observed and cited on a following page.