Routine inspection·January 30, 2024

Licensing Program Analyst (LPA) Cuadra arrived unannounced to conduct an Annual Required Inspection and was greeted by Administrator, Teresita Shevick. Required postings observed. Annual fees current. LPA/Administrator initiated a tour of the facility at 9:00 AM and made the following observations: Facility consists of two stories but residents occupy only the lower floor. Door to staff living areas were locked. Laundry room was also locked. 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 112.5, 112.8 and 110.5 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 was 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 in a cabinet and in a locked box in the refrigerator. Facility has a camera without audio in the common living room. LPA confirmed that there were not any cameras in resident rooms. Fire extinguisher was last inspected January, 2023. Smoke alarms tested were operational as well as the Carbon Monoxide detector. Exit doors have auditory alerts that were functional at time of visit. Last disaster drill conducted on 2018. Medications & medication records reviewed. File review was initiated at 9:30 AM. Three staff files and four resident files were reviewed. All residents care plan and medical assessment has been updated within the last 12 months. Staff have required 1st aid/CPR certificates, but 3 out of 3 (S1, S2 & S3) staff have not completed their 20 hours required annual training. Administrator Certificate for Administrator, Teresita Shevick 6006577740 expires 8/13/25. Administrator to submit updates of the following documents by 2/6/24: Designation of Administrative Responsibility (LIC308), Personnel Report (LIC500) and a copy of Liability Insurance. 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 Administrator and copy of this report was given.