Routine inspection·January 23, 2025

Licensing Program Analyst (LPA) Christine (Dolores) Kabariti arrived unannounced to conduct the facility's annual required 1-year inspection. LPA met with House Manager/Designated Administrator, Avelina Pascua. During visit, LPA toured the facility with the staff to include the living room, dining room, kitchen, activity room, bathrooms, garage, resident bedrooms, staff bedrooms, and backyard. 6 clients observed in the facility. All fire exit routes were free and clear of obstruction. Carbon Monoxide detector present and operable. Fire extinguisher last serviced on 01/06/2025. Facility temperature maintained at 76 degrees F. All staff present are fingerprint cleared and associated to the facility. Resident bedrooms observed well maintained with beds, clean linens, dressers, night stands, and adequate lighting. The facility has an approved exception request for the use of a postural support for one resident. Bathrooms supplied with hygiene products, paper supples, and non-slid mats. Hot water temperature maintained at 118 degrees F in the bathroom next to the garage and office. Designated ADM states the bathroom in front of the office will be renovated to include a walk in shower. ADM states they will inform Licensing once renovation begins. Facility has 2 other showers to use for the residents while renovation is in place. 3 resident files were reviewed and observed complete. 3 resident's centrally stored medications and records observed maintained. 3 resident's P&I money was counted with ADM and no issues were noted. See LIC809-C. 3 staff files were reviewed and observed complete. 3 out of 3 staff has a 1st aid certification. 3 out of 3 staff has updated annual training to include topics of dementia, postural support, restricted health care condition, hospice care, and infection control. Facility has an infection control plan. Facility has an emergency disaster plan. Emergency drill last conducted on 11/2024 and the next drill is scheduled for 2/2025. LPA observed the facility has ready to go emergency bins which includes PPE supplies, non-perishable foods, and emergency lighting. LPA observed the facility has a complete first aid kit. Records to update the facility file is requested by 01/28/2025. Licensee received the list of documents to submit to licensing via email. No deficiencies were cited per California Code of Regulations, Title 22. This report was reviewed House Manager/Designated Administrator, Avelina Pascua and a copy of the report was provided.