Routine inspection·April 24, 2025

LPA Audrey Jeung toured facility and grounds, consisting of 11 client bedrooms--3 of which are shared--all with full private bathrooms. All but 3 rooms have direct access to enclosed paved patio. No accessible bodies of water or fire safety hazards observed. PPE supply is adequate and first aid kit is complete. Perishable and non-perishable food supply is maintained. Infection control signs are prominently posted. Medications, toxins and sharps are stored appropriately and inaccessible to clients, a comfortable temperature is maintained, and lighting is sufficient for comfort and safety. Hot water temperature is tested at 119 degrees in bathroom in room #2. Toilet and bathing facilities are equipped with grab bars and nonskid flooring material. Liquid soap is available at all sinks. A Disaster and Mass Casualty Plan is accessible to staff. There are 2 caregivers working. Criminal record clearances or exemptions for facility staff or other individuals who have client contact have been reviewed. Linda Ishii-Chan and Bhawana Shah are certified RCFE administrators (x3/26 and 7/25) that oversee facility operations. Client files are reviewed. There are 2 clients receiving hospice care. Staff files will be reviewed at a later date. The following updated forms/information are requested to be submitted to CCLD BY 5/8/25: • Proof of current Liability Insurance • Hospice plan of operation • Bedridden plan of operation • Updated facility sketch, including correct room numbers Deficiencies of the RCFE California Code of Regulations, Title 22, Division 6, Chapter 8 are observed and cited on a following page. See also Technical Advisiory Notes--4 pages.