Routine inspection·April 17, 2024

On April 17, 2024 Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. LPA met with caregiver, ILdefonso Maning and explained the purpose of the visit. The administrator, Dino Martin arrived shortly thereafter and assisted with the inspection. Kitchen area was toured. Cabinets and drawers were reviewed. Food supply was reviewed for adequate 2-day perishable and 7-day nonperishable quantities at this time. A tour of the dining area, living area, and all other areas intended for resident use was conducted. Medication and sharps cabinets were locked located in the kitchen area and inaccessible to residents in care. A tour of the resident bedrooms and restrooms was conducted. The facility is approved for 1 bedridden resident in room 4, however, LPA observed 1 bedridden resident is residing in a non-approved bedridden room. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. Hot water temperature was taken and measured to make sure that it was within the allowed range of 105-120 degrees. 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. There are 6 residents present, and 3 staff but 1 staff left during the inspection due to lack of criminal background clearance. A review of (5) facility resident records was conducted. A review of (4) facility staff records was conducted. Garage area was toured. LPA observed half of the garage was blocked off by green partition with two tents inside; each tent consisted of a mattress and around the tents, there were toiletries, clothing, shoes, etc. The administrator acknowledged that the facility altered this space as facility staff living space without permit. The garage area also housed the washing machine and dryer for this facility's use at this time. Laundry area was toured. Cabinets storing detergents and bleach were observed to be unlocked and accessible to the residents at this time. Fire extinguishers were inspected on 10/26/2023. Facility was not able to provide documentation to proof that emergency drills were completed accordingly. The following forms and documents were requested to be updated and submitted into CCL by 4/22/24 - control of property, and liability insurance 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. Civil penalty is being assessed today for repeat violation, lack of criminal background clearance for one staff, a bedridden resident is residing in a room that is not cleared by fire marshal and 2 out of 4 staff members were not associated. Civil penalty will continue to accrue until corrected. This report is reviewed and discussed with administrator. A copy of this report and the appeal rights were provided.