Routine inspection·July 10, 2025

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a required Annual inspection and was greeted by caregiver. Administrator Isabel Melanson arrived later, Administrator Certificate 7024381740 expires 2/8/27. At approximately 9:45am LPA toured the building and grounds. LPA 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. Kitchen area is accessible only by half door. Kitchen drawer with sharp knives locked. Kitchen range/stove has a broken oven door such that it does not close properly and range burners are clogged such that the burners do not operate properly ( deficiency cited, see 809D) . Kitchen range does not have overhead vent or ventilation system. Kitchen does have cathedral style window with vent on the side, but vent does not have functional operation switch ( deficiency cited, see 809D ). Carpet just outside of kitchen at entrance to the long hall is heavily soiled and has a wearing hole that has grown in size and presents as a tripping hazard ( deficiency cited, see 809D ). Laundry room in long hall has cabinet that stores cleaning solutions and toxins; however, cabinet framing is heavily worn down such that the locking feature does not always securely lock, leaving toxins accessible to residents ( deficiency cited, see 809D ) All bedrooms were equipped with lighting, night stand, and chest of drawers. All bedrooms were clean and in good repair. Extra hygiene products and linens were available. Resident bathrooms had required bath mats and grab bars. Water temperatures in sinks accessible to residents in care measured at 128.4 degrees F in room #12 and 124.7 degrees F in room #15 but measured 94.3 degrees F in jack and jill style bath in room #9/#10 and 87.8 degrees F in main bathroom next to kitchen. Water temperatures are therefore both over and under the allowable range of 105 to 120 degrees F ( deficiency cited, see 809D ). Continued on 809C... Continued from 809... At approximately 12:00pm LPA conducted a review of six [6] resident records. All required documentation present. Resident (R1) had bedridden status on their physician's report however Admin assessed R1 in wheelchair and questions bedridden status. LPA advised of regulation for bedridden residents and advised to notify local fire department of bedridden status, but that they can also contact the physician to correct the physician's report. Admin agreed to both and will report back to LPA the findings of the doctor and fire department. Admin will also provide LPA with proof of notification to fire department. LPA advised Admin if fire clearance is granted for bedridden residents, staff will need to receive training per regulation 87606 and facility must meet all other requirements of regulation 87606 as well as Health and Safety Code 1569.72, respectively. At approximately 1:30pm LPA conducted review of five [5] staff records. All required documentation present. At approximately 2:30pm LPA and Admin conducted a spot check of medication and medication records. Medication is centrally stored in locked cabinets. 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 with Administrator and a copy of this report was given .