Routine inspection·June 11, 2024

Licensing Program Analyst (LPA) Cuadra arrived unannounced to conduct an Annual required inspection and met with Licensee, Emilce Deller. Fees are current. Contact information was reviewed. There are residents with diagnosis of dementia. LPA initiated a tour of the facility at 1:00 pm and made the following observations: Facility was a comfortable temperature and passageways were free from obstructions. Resident rooms were furnished per regulation. Water temperature in resident's bathroom measured at 105.3 and 106.1 degrees F which are within allowable range of 105 to 120 degrees F. Extra hygiene products and linens were available. Bathrooms had required bath mats and grab bars. Toxins were inaccessible to residents in care. Facility has at least two days of perishable and one week of non-perishable foods. Medications were centrally stored and locked. Fire extinguisher was last inspected June, 2024. Smoke detectors and carbon monoxide detectors located throughout the facility were tested and operational. Exit doors have auditory alerts that were functional at time of visit. Last disaster drill was conducted on 3/23/24. File review was initiated at 1:30 pm. Three staff files and six resident files were reviewed. One out of three staff do not have required 1st Aid/CPR certificates (technical violation issued). One out of six residents (R1) do not have a current medical assessment within the last 12 months. Three out of six residents (R1, R2 & R3) do not have a care plan updated within the last 12 months as indicated in regulation. Administrator Certificates for Licensee Emilce Deller, 6010293740, expires on 2/26/26. Training records were reviewed. Licensee agreed to submit updates of the following documents by 6/28/24: Designation of Administrative Responsibility (LIC308), Personnel Report (LIC500) and control of property. 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. Exit interview conducted with Licensee and a copy of this report was given.