Routine inspection·May 31, 2024

LPA Audrey Jeung toured facility and grounds, consisting of 6 private client bedrooms--all with full private bathrooms--and 2 staff bedrooms--one staff room has 2 beds and the other has 3 beds. The common area consists of living/dining area and kitchen. Laundry and storage area is adjacent to a staff room. No accessible bodies of water or fire safety hazards observed. PPE supply consists of surgical masks and gloves only. 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. First-aid kit is inspected and complete. An updated Disaster and Mass Casualty Plan is posted. There are 5 residents present, and 3 staff. Four residents are receiving hospice services. Client records and staff records are reviewed, including criminal record clearances or exemptions for facility staff. Rafael Jison is a certified RCFE administrator that oversees facility operations. The following updated form is requested to be submitted to CCLD BY 6/7/24: • LIC 309 Administrative Organization Proof of current Liability Insurance is given to LPA today, along with LIC 308, LIC610, LIC500. Deficiency of the RCFE California Code of Regulations, Title 22, Division 6, Chapter 8 is observed and cited on a following page.