Routine inspection·April 18, 2024

On April 18, 2024 Licensing Program Analyst(LPA) Murial Han conducted an unannounced annual inspection. LPA was greeted by caregiver, Jannette Sumampong. LPA explained the purpose of the visit. LPA toured facility and grounds. No accessible bodies of water or fire safety hazards observed. LPA toured inside and outside including all of resident rooms, common areas, and kitchen area. The indoor and outdoor passageways were free of obstruction. Comfortable temperature is maintained and lighting is sufficient for comfort. LPA observed 5 resident rooms (5 private rooms) and 1 staff room. Rooms were spacious and included all required furnishings. Bathrooms were observed to be clean; equipped with paper towels, soap, grab bars, and non-skid mats. Hot water temperature in the kitchen, and bathroom was measured at 106- 111 degrees F. 2 days for perishables and & 7 days non-perishable were observed to be present. During the tour of the garage, LPA observed the garage was sectioned off in the middle; one side is for laundry, toxins and chemical storage, etc. and the other side consisted of: a folding bed, clothing, a laundry basket with clothes inside, toiletries, portable storage units, a personal check, a wallet, etc. Facility is equipped with smoke detectors and carbon monoxide detectors. Fire drill records were reviewed. A review of (3) facility resident records was conducted. A review of (3) facility staff records was conducted. During today's inspection, there were 3 residents and 3 staff present. LPA requested these documents to be submitted by 4/22/2024: 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. This report is reviewed and discussed caregiver. A copy is provided and the appeal rights.