Routine inspection·February 14, 2025

Licensing Program Analysts (LPAs) Christi Coppo and Elias Magdaleno arrived unannounced to conduct a required Annual inspection and was greeted by licensee Luningning Alicdan. At approximately 9:30am LPAs and licensee toured the building and grounds. The facility was found to be clean and at a comfortable temperature. LPAs observed at least a 2 day supply of perishable and 7 day supply of non-perishable food. Food was found to be stored in a safe manner with open items covered. Garage cabinet containing cleaning supplies was unlocked, LPAs discussed with licensee cabinet must remain locked at all times. Kitchen drawer with sharp knives locked. All bedrooms were equipped with lighting, night stand, and chest of drawers. Extra hygiene products and linens were available. LPAs observed resident room 2 had commode full of waste and urine, with very strong odor filling the room. LPAs observed resident room 4 to have strong odor from urine as well. LPAs discussed with licensee importance of keeping facility and residents free from odors of incontinence (deficiency cited see 809D) . Hallway floor in front of water heater closet outside of main hall bath has water damage. Per licensee, water damage caused by leaking water heater that was recently replaced. LPAs and licensee observed the laminate flooring was uneven as a result of damage and bowed inward under weight (deficiency cited see 809D) . Resident bathroom had required bath mat and grab bar. Water temperature in sinks accessible to residents in care measured at 119.3 degrees F in hall bath and 117.6 degrees F in room 1A/1B which are within the allowable range of 105 to 120 degrees F. Fire extinguishers were last inspected 5/31/2024. Smoke/Carbon Monoxide detectors located throughout the facility were tested and operational. Facility’s last quarterly disaster drill was conducted 12/5/24. Facility has a backup generator for use during a power outage. Continued on 809C... Continued from 809... At approximately 11:30am LPAs conducted review of five (5) staff records. Three (3) of five (5) staff (S1, S2, S3) did not have First Aid (deficiency cited see 809D) . Two (2) of five (5) staff (S2, S3) were not associated with facility. However, licensee has previously discussed with LPA issue they are encountering with Guardian and being locked out/not able to access their account. LPA previously advised licensee that when they experience a pinch with Guardian to notify LPA and send LPA form LIC9182 so that LPA can associate the staff member to the facility. Licensee agrees and will immediately send LIC9182 to associate S1 and S2. Both S1 and S2 had fingerprint clearance and proof of clearance on file. At approximately 1:10pm LPAs conducted a review of six (6) resident records. No deficiencies. At approximately 3:00pm LPAs and licensee conducted a spot check of medication and medication records. Medication is centrally stored in a locked cabinet. No deficiencies. Luningning Alicdan Administrator Certificate 7002894740 expired 10/10/2023, LPAs verified licensee is in pending renewal stauts. All fees are current as of this time. 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 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 Caregiver. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Caregiver and a copy of this report was given .