Routine inspection·May 12, 2023

On 5/12/2023 Licensing Program Analyst (LPA) Tobola conducted an unannounced Annual Required – 1 yr. inspection for this facility and was greeted by staff Ana Montes and Administrator, Gaylord Almogela. The facility currently provides care for 3 residents, none of which are on hospice or a diagnosis of dementia. Residents were currently at day program at the time of visit. LPA arrived at the facility and had temperature checked and logged. LPA continued with a tour of the facility with Administrator and facility staff; facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguisher was found to be last charged on 1/16/2023 at the time of the visit. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Food stored in the kitchen refrigerator were properly stored and labeled as per regulations on this day at the time of the visit. Toxins are stored under the kitchen sink and in the garage and found to be secured. There was a supply of cleaners, hygiene products and paper products available for residents. All resident’s bedrooms have lighting & appropriate furnishings. Hot water measured at 118.9 and 119.4 degrees F which is within Title 22 regulations of 105 to 120 degrees F in faucets used by residents. Smoke and carbon monoxide detectors were tested and found to be in working order. Spot medication check was conducted and centrally stored medication records were found to be in order. Upon review of Guardian staff roster, LPA found that staff (S1) is not properly associated to the facility. Administrator stated that S1 was assisting as a volunteer but will review with Licensee of any fingerprint documentation for clearances. Staff training files were reviewed and found all staff to have proper 1st aid & CPR training on file. Continued onto LIC809-C Infection Control: All staff and residents have been vaccinated and received boosters with no reported or observed symptoms. Posters have been placed at the front door, and facility has a station at main entrance with a sign in, hand sanitizer and other items designated for visitors and staff. Staff are screened for temperature and symptoms on a daily basis and residents are screened based on changes of condition or symptoms. Gaylord Almogela's Administrator certificate is valid through 3/22/2024. LPA requested the following documents be sent to CCL by COB 5/26/2023: LIC 308 Designated Facility Responsibility LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan LIC 9020 Register of Facility client’s/client’s Copy of Administrator Certificate(s) Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12-month period may result in civil penalties. Civil Penalty is also being assessed in the amount of $100.00 due to one (1) staff not properly associated to the facility. Today's total assessment of $100.00 for each staff is for violation of Title 22 Regulation # 87355(e) & 87412(b)(3)