Routine inspection·September 25, 2025

At approximately 10:00am, Licensing Program Analyst (LPA) Contreras arrived unannounced to conduct a required annual inspection visit. LPA was greeted by facility administrator (admin) Romulo Bautista. Facility is a Residential Care Facility for the Elderly that has a fire clearance approved for six ambulatory of which 6 may be non-ambulatory. Facility has approved hospice waiver for 2 residents. LPA toured the building and grounds which was found to be clean and in good repair. Facility was clean and at a comfortable temperature. LPA observed all walkways and exits to be unobstructed. All required postings were in a highly visible area. Fire extinguishers were charged and last inspected 07/01/2025. Fire alarms and carbon monoxide detector were tested and operational. All signal alarms throughout facility were operational and functional. Outdoor emergency exit clear from obstruction. LPA observed the 2 day supply of perishable food requirement to be lacking per Title 22 Regulations. Refrigerator appeared to be lacking the proper nutrients and food supply to meet residents dietary needs. Refrigerator in garage observed to store mainly bread. Freezer had ground beef, patties, and fish unlabeled with no expiration dates noted in ziplock bags. LPA had conversation with admin that there should be sufficient perishables in refrigerator and freezer to be enough for 2 days and food must be labeled with expiration dates including proper storage. Facility kitchen, refrigerators and freezers were clean. Toxins are stored in a locked cabinet and inaccessible to residents. Sharps and knives were locked in pantry. Facility had emergency water to meet regulations but lacked the 72 hour supply of emergency food (Advisory given). **During inspection, facility brought groceries with enough food supply to meet Title 22 Regulations. Admin and LPA had thorough conversation about food service with advisory. Facility to send food grocery receipts for the next 3 weeks to ensure food service compliance. Failure to comply may face potential citation and civil penalties from CCL. Continued onto 809C... continued from 809C.... All bedrooms were equipped with lighting, a night stand and chest of drawers. All bedrooms were clean and in good repair. Resident bathroom had required bath mat and grab bar. Facility had an ample supply of linens, towels and extra hygiene products for residents. Water temperature measured at 116.6 degrees F at faucets accessible to residents which is within the allowable range of 105 to 120 degrees F. Disaster drills are conducted monthly with the last drill conducted on 8/02/2025. LPA reviewed 6 of 6 resident records. All required documentation was present. Physician reports were up to date. LPA reviewed 4 staff records. All documentation found up to date. LPA and Admin conducted a spot check of medication and medication records. Medication is centrally stored in a locked cabinet. Medication was observed to be pre-poured for the next morning not in its original containers (Deficiency Cited, See 809D). Medication PRN was not listed in Centrally Stored Log( Advisory given). Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: LIC500- Personnel Report LIC308-Designation of Responsibility Liability Insurance Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Appeal rights given and discussed with Administrator. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and report read with Administrator.