Routine inspection·November 17, 2023

Licensing Program Analyst (LPA) Araceli Canela arrived unannounced to conduct a Required - 1 Year inspection and met with, care staff, Angelita Rebujio (S1), and toured the entire inside and outside with S1. Administrator/Licensee, Zenaida Almogela, was then called and arrived a few minutes later. There are currently 4 residents in care and they receive services from North Bay Regional Center (NBRC). This facility is licensed for 6 non-ambulatory residents, no approval for bedridden. LPA toured facility and grounds and observed all required signs posted in common areas. Infection control practices are present. Facility has a 30-day supply of PPE. Facility has also submitted their Infection Control plan, which is a part of their Plan of Operation. Facility was found to be at a comfortable temperature with all exits free from obstruction. Facility has at least two days supply of perishable and one week of non-perishable foods and items are stored properly. Fire Extinguisher was fully charged, and have proof of being serviced on 1/16/2023. Smoke detectors and carbon monoxide detectors were tested and operational. Fire drills are conducted and the last one was documented on 10/10/2023. Water temperature in the resident bathroom was tested and found to be within appropriate range of 105-120 degrees. Bathrooms were clean and sanitary with non-skid mats/floors and grab bars. The outside grounds have plants, fruit trees, and provide easy access for the residents to enjoy fresh air. Resident and staff files are located and locked in closet. LPA reviewed resident files and were found complete and organized. Staff files were complete, organized, with proof of required annual training and CPR/1st Aid certificates expiring 4/19/2025. Continue report see LIC809-C Administrator certificate for Gaylord Almogela # 6014716740 expires 3/22/2024. LPA discussed Emergency Disaster Plan and Infection Control Plan. Licensee/Administrator to submit copies of the below documents by 12/17/2023. · LIC 308 Designation of Facility Responsibility · LIC 500 Personnel Report- · LIC 400 Affidavit Regarding Client/Resident Cash Resources · LIC 610E Emergency Disaster Plan · LIC 9020 Register of Facility Residents Infection Control Plan of Operation (If changes) Copy of Liability Insurance- Copy of Administrator Certificate No citations issued during todays inspection.