Routine inspection·July 10, 2024

Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced Annual required inspection at the facility. Upon arrival, LPA was greeted by Omar Garcia, Program Manager and Monica Gomez, Clinical Case Manager. Jennifer Farley, Program Director was unavailable at the time of the visit. LPA explained the purpose of the visit. There are currently fourteen (14) clients residing in the facility. At the time of arrival, there were fourteen (14) clients present with five (5) staff were on duty. Entrance interview conducted. The facility is a one-story home to Clients with intellectual/developmental disabilities, has a fire clearance for 15 non-ambulatory clients and a hospice waiver for 2 clients. Currently, there are no residents on hospice. The facility contracts with Tri-Counties Regional Center. A tour of the physical environment and accommodations were assessed, and the following was noted: LPA observed the required posting of the complaint poster and Resident’s Rights. LPA inspected the one-story facility for fire safety, personal accommodations, and food service. The physical environment was checked for cleanliness and condition. Walls, windows, ceilings, doors, floors and floor coverings were checked. The facility was seen to be in good repair inside and outside. LPA observed five (5) fire extinguishers serviced on 4/3/2024, two (2) carbon monoxide detectors in good working order, 27 smoke alarms, and an automatic sprinkler system throughout the building. The kitchen area was sufficiently stocked with two-day perishables and seven days of non-perishables. Frozen foods are properly wrapped and stored appropriately. LPA observed the kitchen cabinets, refrigerator, stove, and counters are clean. A weekly meeting is conducted with Staff in Charge (SIC) to discuss clients’ activities and planning for the activities for the upcoming week. Clients participate at will in activities with holiday celebrations, birthdays, self-accomplishment celebrations, weekly acknowledgements, painting projects, Bingo, and greenhouse planting. A plan is in progress for the residents to participate in a day trip to Disneyland which will include groups of five residents in three different sessions. Please continue to 809-C.Page 2 Clients also participate independently in arts and crafts, excursions to the local eateries, museums, and parks, entertainment places, walks, and places of worship. Medications and First Aid kits are kept in the locked staff office in a locked medication cart. Meals are prepared by the facility cook. Staff assists with meal distribution and assisting clients with safety precautions and special diet accommodations. Snacks are available throughout the day. Clients may volunteer to complete chores throughout the facility if desired. The front entrance consists of an open porch with a bench located near the front door. The facility maintains a comfortable temperature and there are no bodies of water. The facility has twelve (12) bedrooms. Bedrooms #1, 5, and 9 are shared bedrooms. Bedroom #9 has a private bathroom for the two occupants. Bedrooms #11 and 12 are single rooms with a shared bathroom between the two rooms. Bedrooms #2, 3, 4, 6, 7, 8 and 10 are private bedrooms. There are 5 bathrooms with access from the hallway available to all clients and staff. The bathrooms have secure grab bars. All staff have been properly associated to the facility. Record review and interviews conducted revealed facility staff have have not received the yearly 20 hours of training in dementia, postural supports, restricted health conditions, and hospice care. The following deficiencies were observed (See LIC 809-D) and cited from the California Code of Regulations, Title 22. Failure to correct the deficiencies may result in additional civil penalties. Exit interview conducted. Due to technical difficulties copy of the report and appeal rights were provided via email.