Routine inspection·October 10, 2024

Licensing Program Analysts (LPAs) Marcella Tarin, Manuel Monter and Steve Chang conducted an unannounced annual inspection visit, and met with Administrator Isabel Eslava. ADM informed LPAs that the facility has 2 staff and 6 clients. LPAs toured the facility inside and outside which included: kitchen, office area, 6 resident rooms and 3 restrooms. 6 out of 6 resident bedrooms had functioning lights, a chair, clean bedding, dresser and storage space for residents personal belongings. LPAs observed a perishable food supply of at least two days and a non-perishable food supply of at least seven days. LPAs observed the sharps and chemicals storage area locked underneath the kitchen sink. The staff area of the facility was also inspected. The front yard and backyard of the facility was also inspected. While touring the backyard, LPAs observed a trash can and recycling can obstructing the walkway, directly next to room #1. The path the trash can and recycling bin were obstructing are on the emergency evacuation path. (Photograph was taken). LPAs also observed a container of dish soap and fabric softener near the garage door on the side of the home. (Photograph was taken). ADM removed the chemicals and locked them away during visit. LPAs observed two sheds in the backyard that are being used for storage. While touring bathroom #3, LPAs observed a bottle of Oxiclean stain remover in the shower and a Clorox toilet cleaner, near the toilet (Photograph was taken). ADM removed chemicals/cleaning products during visit. While touring hallway next to bedroom #3, LPAs observed Ortho flea & tick killer in hallway linen closet (photograph was taken). ADM removed Ortho flea & tick killer to a locked storage area. LPA observed the medication storage area, knives storage area, and cleaning product storage area as locked and inaccessible to clients in care. The hot water temperature in 3 out of 3 hallway resident restrooms was measured at 105.4 and 105 degrees F. Page 1 Out of 2. The facility was equipped with smoke and carbon monoxide detectors. All smoke detectors functioned properly when tested. Fire extinguishers were last serviced on 05/08/2024. LPAs observed the facility first aid kit and it was observed to be complete. LPAs requested to review the facility fire drill log. ADM stated she does conducts drills but does not have any documentation. LPAs reviewed facility records for 3 staff and 3 clients, which were all found to be complete during review. LPAs reviewed 5 clients medications and centrally stored medication records and found the centrally stored medication records to be complete. LPA interviewed 2 staff. Deficiencies are being cited during today's visit as per California Code of Regulations Title 22. See LIC809-D This report was reviewed with ADM Isabel Eslava and a copy of the signed report was provided. Appeal Rights were provided. Page 2 Out of 2. END OF REPORT.