Routine inspection·November 26, 2024

Licensing Program Analyst (LPA) Araceli Canela arrived unannounced to conduct a Required - 1 Year inspection and met with, care staff, Eller Obias. Administrator, Grace Caramat was called but was unable to meet with LPA. LPA requested facility to submit a current LIC500 identifying the days and hours the administrator works in the facility. LPA also requested facility to submit the required paperwork to Community Care Licensing (CCL) to change the. There are currently 6 residents living in this facility. This facility is licensed for 6 non-ambulatory residents, with no approval for bedridden and there is a Hospice waiver for 3 of the residents. LPA toured facility and grounds and observed facility was found to be clean at a comfortable temperature with all exits free from obstruction. Resident rooms have the required furnishings and linens. Medications are stored locked in a locked cabinet in the hallway closet. Extra hygiene products and linens were available and will be kept in the laundry area and extra in the garage. Facility understands they need to remove all the linens that are being kept in the dresser in a residents room. Facility understands they may not use the residents room and space to store all the facility linens. Fire Extinguisher was found to be charged and serviced on 9/18/2024. Carbon monoxide detector was found to be operational, smoke detectors were tested and operational. 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 as per regulations. Toxins sharps and medications are locked and not accessible to residents. During the inspection an additional staff showed up to do activities with the residents and explained they do this several days a week with this and 2 other sister facilities. LPA reviewed 6 of 6 resident files and facility will need to update 3 of 6 resident admission agreements. Facility complete staff files were not available. Continue report see LIC809-C LPA requested the following updated records to be submitted to Community Care Licensing by 12/22/2024. LPA will need to return to review staff files and requested clarification and an updated LIC602 for resident R1. · LIC 308 Designation of Facility Responsibility · LIC 500 Personnel Report · LIC 610D Emergency Disaster Plan · LIC 9020 Register of Facility Residents · Copy of Liability insurance Copy Admin Certficate Exit interview conducted with Eller Obias No deficiencies cited during this inspection