Routine inspection·March 27, 2025

On March 27, 2025, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual visit. LPA met with Administrators, Juliet Pacaldo and Paula Madrigal and explained the purpose of the visit. LPA toured the facility including a random sample of resident rooms, common areas, and kitchen area. The indoor and outdoor passageway was free of obstruction. No accessible bodies of water of fire safety hazards observed. This is a two story facility. LPA observed resident rooms; some of which are single private rooms and some of which are shared. All resident rooms were observed to be odor-free with all required furniture. Bathrooms were observed to be clean and odor-free. During the visit, LPA observed a broken hot water faucet in resident's bedroom. Water temperature throughout the facility measured between 130-135 degrees F. Extra linen was observed to be present. First aid kit was observed to be complete. Dining room was observed free from tripping hazards. A comfortable temperature is maintained and lighting is sufficient for comfort. LPA observed two day perishables and seven day non-perishables. On the second floor, LPA observed flies right outside the kitchen, with no window or door blocking the flies from going inside the kitchen. LPA observed flies in the kitchen while staff were cooking. Sharps were observed in the kitchen, inaccessible to residents. LPA observed a door near the kitchen in disrepair. Chemicals were observed locked and inaccessible to residents, however there was a chemical storage room on the second floor near the kitchen had no door knob and a hole in the wall. There was a tie that went through the hole in the wall and the door knob to lock the door. During the tour, LPA observed the medication cart on the first floor to be locked and inaccessible, however LPA observed the nurses' station on the second floor with the key attached on the door. LPA observed multiple staff rooms on the second floor. (continue to 809C). Carbon monoxide monitors are working properly. All fire extinguishers have been checked and current as of February 2025. Emergency drills are logged and done every three month. LPA reviewed 5 resident records and 5 staff records. LPA observed 2/5 resident admission agreements to not be signed by resident or resident's responsible party. Staff records are complete, with training logs that have met the basic requirement. Medication review was done, and all medications are accounted for, and centrally stored medication records are updated. Deficiency was observed during the visit and cited from the California Code of Regulations, Title 22 and Health and Safety Code. See LIC809-D. Failure to correct the deficiencies may result in civil penalties. Report is reviewed with Administrators and a copy is provided.