Routine inspection·August 28, 2025

At approximately 10:00 AM, Licensing Program Analyst (LPA) Star Stevenson arrived unannounced to conduct a required 1-year annual inspection and was greeted by caregivers who called Administrator Kristine Lorenzo and Administer-to-be Van Eduard-Alverez who arrived at approximately 10:25 AM. Facility is a Residential Care Facility for the Elderly (RCFE) with six (6) residents in care, two of whom were away at Day Programs during today's visit. Facility has a Hospice waiver for three (3) and a Dementia Care Plan and currently has one resident identified with dementia and none are receiving hospice care. Faculty is vendorized with North Bay Regional Center (NBRC) At approximately 10:25 AM, LPA initiated a tour of the facility with Caregiver/Administrator and observed the following: Facility is a one story home, was a comfortable temperature, and passageways were free from obstructions. Water temperatures in residents' bathrooms measured within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed a supply of clean linens and paper and incontinent care products available to residents. Residents' bedrooms were inspected and observed to have appropriate furnishings as outlined in Title 22 regulations. Cabinets containing cleaning supplies and other items that could pose a risk were locked. Facility has at least two days of perishable food and one week of non-perishable foods, as well as an emergency water supply and large emergency generator. LPA noted go-bags and buckets of non-perishable foods for each resident. LPA noted large televisions, and large reclining chairs and couches for resident/staff use. There is a covered seating area in the backyard with outdoor space for activities. LPA observed a locked shed in the backyard which LPA inspected and observed the contents to consist of tools, chemicals, decorations, extra incontinent care products, PPE, a couch and two desks set-up for use as an office space. LPA observed an activity schedule and games, crafting supplies, and other activities available for resident use. Facility has an internet access device (an iPad) and internet service available to residents in care. Continued on LIC809-C... Continued from LIC809C... Medications, sharps and toxins were stored and locked. The telephone was noted to be operational during inspection. Facility's fire extinguisher was observed charged and was last serviced 06/2025. Centrally wired Smoke detectors were tested and operational during inspection. Carbon Monoxide detector was tested to be operational. Facility conducts monthly disaster drills, and the most recent drill was conducted 08/01/2025. LPA observed the facility's dementia plan LPA reviewed facility's emergency disaster plan last updated 01/09/2025 At approximately 11:30 AM, LPA conducted file review of six (6) resident files and observed the following: six (6) of six (6) resident files reviewed contained all the required documents per Title 22 regulations, including MD orders for Hoyer lifts and half-bed rails at head of bed and wheelchair/self-releasing lap/safety belts when appropriate (LPA obtained copies of these MD order for each resident) At approximately 1:00 PM, five (5) staff files were reviewed. Five (5) of five (5) staff files reviewed have all of the required paperwork, including CPR and First Aid training and documentation of all required initial and annual training hours, health record, criminal clearance and negative TB testing. At approximately 12:50 PM, LPA conducted a spot review of centrally stored medications and medication records which were observed to be within compliance with regulation. Caregiver/Administrator states facility and residents' families work together to coordinate medical and dental appointments and transportation to and from visits. Facility now handles P&I monies for NBRC residents and an LIC400 Affidavit regarding Resident Cash Resources, as well as, copy of valid and appropriate Surety Bond was obtained by this LPA. LPA obtained copies of updated Lability insurance, LIC610E (Emergency Disaster Plan), LIC500 Personnel Report, LIC9020 Register of Facility Residents, LIC400 Affidavit Regarding Resident Cash Resources, LIC402 Surety Bond Technical advisory cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. No Deficiencies are cited today