Routine inspection·June 23, 2025

LPA Audrey Jeung toured facility and grounds of this RCFE for mentally disabled elderly. There is a swimming pool in backyard, but it is surrounded by a metal fence about 5 feet high. No fire safety hazards are observed. There are 3 shared bedrooms for residents and 2 bathrooms--one designated for residents. In addition, there are 2 staff rooms--one is occupied by 3 live-in staff and the other is an office with a bed for administrator/licensee. There is a detached storage shed in backyard. Washer and dryer are located in the attached two car garage. Carbon monoxide detector is tested and operable. There are 4 exit doors--3 of which exit to fenced yard. There is an alarm on front door, but it is NOT secured. Exit gate from backyard to street is alarmed, but is NOT secured. Door from garage is accessed by a passcode. Facility has fire clearance for secured perimeter. . Medications, toxins and sharps are stored appropriately and inaccessible to clients, a comfortable temperature is maintained, and lighting is sufficient for comfort and safety. Hot water temperature tested at 105 degrees in clients' bathroom. Soap and paper towels are present in bathrooms and kitchen sink. Toilet and bathing facilities are equipped with grab bars and nonskid flooring material. First-aid kit is inspected and complete. A Disaster and Mass Casualty Plan is posted. There are 4 residents present, and 3 staff. Criminal record clearances or exemptions for facility staff or other individuals who have client contact are reviewed, as well as other staff and client records. Personal and incidental cash transaction records are maintained accurate, including safeguarded cash for 4 residents. Bernellet Taa a certified RCFE administrator (x 8/25) that oversees facility operations. Continued on next page. The following forms/information are requested to be updated and submitted to CCLD by 7/7/25: - Administrative Organization (LIC309) - Designation of Administrative Responsibility (LIC308) - Affiavit regarding Client Cash Resources (LIC400) - bedridden plan of operation - medication training requirements for staff - proof of current liability insurance Emergency Disaster Plan (LIC610E) is provided to LPA today. No deficiencies of the General Licensing Regulations, of the California Code of Regulations, Title 22, Division 6, are cited. See Technical Advisory Notes--2 pages--for additional information.