Routine inspection·January 24, 2025

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required - 1 Year visit and met with Yuly Arita, Office Manager. During visit, LPA toured the facility inside and out. LPA toured the kitchen area. LPA observed there to be locked drawers for sharp objects and cleaning supplies. LPA observed there to be a perishable food supply of at least two days and a non-perishable food supply of at least seven days. LPA reviewed the first aid kit and found it to be complete. LPA toured the hallways and 6 out of 6 resident rooms. The smoke detectors in the hallways and in the resident rooms all functioned properly when tested. Two out of two carbon monoxide detectors functioned properly when tested. LPA toured two out of two resident bathrooms. Each bathroom had available soap and paper towels as well as functioning lights. The showers had anti-slip mats and shower chairs. The water temperatures in both bathroom sinks measured at 117 F. LPA toured the garage area and observed the garage door had a doorknob that could be locked and unlocked from inside the house. LPA observed that there were laundry detergents on top of the washing machine. LPA advised staff to either change the lock on the garage door so that it cannot be unlocked by residents or to install locks on one of the garage cabinets and store the laundry detergent in the locked cabinet. During visit, staff installed a lock on one of the cabinet inside the garage and placed the laundry detergent inside the locked cabinet. LPA toured the outside of the facility and found both exits to be clear of obstructions. See LIC809-D page for more information. Page 1 of 2. LPA Marrufo reviewed the Centrally Stored Medication and Destruction Record (CSMDR) during visit for residents R1-R5. The following errors were found in the CSMDR: R3 had two medications that were not recorded and R4 had one medication that was not recorded. LPA Marrufo reviewed the resident records for residents R1-R5 and found them to be complete. LPA reviewed the staff records of five staff and found them to be complete. An advisory note was issued. See LIC9102 for more information. A deficiencies was cited as per California Code of Regulations Title 22. See LIC809-D for more information. This report was reviewed with Yuly Arita and a copy of this report and appeal rights were provided.