Routine inspection·April 21, 2023

On April 21, 2023, Licensing Program Analysts (LPA) Komal Charitra and Grace Donato conducted an unannounced annual inspection. LPA met with Caregivers, Mikhail Serrano and Angelo Sunpayco and explained the purpose of the visit. Administrator, Edmund Sunpayco and Co-Administrator, Rose Lo joined shortly thereafter. Upon arrival, LPA observed COVID signage posted on front door and temperatures were taken. LPAs toured the facility and grounds. No accessible bodies of water or fire safety hazards observed. This is a single story home with 4 resident rooms and 2 full bathrooms. LPA toured the resident rooms and observed them to be private rooms with all required furntiure. LPAs observed resident room #3 to have an exit door with an alarm, however the alarm was observed to not be working. In addition, alarm was not working in the office room. Bathrooms were observed to be in good repair and equipped with non-skid mats. LPAs observed living room and dining room to be clean and free from any tripping hazards. A comfortable temperature of 68 degrees F is maintained and lighting is sufficient for comfort. Hot water temperature was measured at 110 degrees F throughout the facility. Staff training records were reviewed; food supplies were observed to be adequate. LPAs toured the kitchen, and observed sharps to be unlocked and accessible to residents. LPAs toured the garage and observed extra food, linen and resident supplies present. Washer and dryer was observed to be in good repair. LPAs observed toxins and chemicals to be unlocked and accessible to residents. According to staff, residents do not have access to the garage. LPAs advised caregivers to still keep chemicals locked. Facility is equipped with smoke detectors and a carbon monoxide detector. Fire extinguisher was last serviced November 3, 2022. Fire drill was last conducted in November of 2022 (Cont to 809C) All staff present at the facility was observed to have fingerprint clearance. Medications were observed to be locked and inaccessible to residents. LPAs reviewed residents and staff records. Resident records contain admission agreement, medical assessment, LIC 602 (Physician Order), Appraisal, Needs and Service Plan, etc. Staff files contain personnel records, health screening, COVID-19 vaccination card, Job Description, Abuse Statement, First Aid, training records. Criminal Record Statement, etc. During the visit, 3 residents were observed in their rooms sleeping and one resident was observed in the dining room. Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC809-D. Failure to correct the deficiencies may result in civil penalties. Report is reviewed with Co-Administrator and a copy is provided with appeal rights.