Routine inspection·December 8, 2023

Licensing Program Analyst (LPA) Cuadra conducted an unannounced Annual Required – 1 yr. and met with Licensee Emma Mutunga. There were 3 residents present at the facility. LPA/staff toured the facility around 12:30pm. The facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguishers were found to be last charged on December 2023. smoke detectors & carbon monoxide detectors were found to be operational during the visit. Last disaster drill was conducted on 10/01/2023. Hot water temperature; it measured 111.4 and 113.1 degrees F which is within acceptable regulations of 105 to 120 degrees F in 2 out of 2 resident’s bathroom faucets. There was a supply of cleaners, hygiene products and paper products available for residents. All resident’s bedrooms have lighting & appropriate furnishings. Toxins are stored in a cabinet in the garage that was locked at time of inspection. Medication is centrally stored and locked in a closet located in the kitchen. Fire extinguishers were last inspected December, 2019. Smoke/Carbon Monoxide detectors throughout the facility were tested and operational. Smoke alarms are hardwired. Auditory alarms were functional at time of inspection. Required postings observed. During today's visit, LPA discussed with Licensee about no activities been observed while LPA was visiting the facility. Per Licensee, residents do prefer not to participate in activities, they prefer to watch television or read the newspaper. At approximate 12:40pm LPA/staff observed four bananas and bag of tomatoes, which does not appear to be sufficient supply of perishable food as required by Title 22 Regulations. There was sufficient nonperishable food observed on premises. Continued on LIC809C... Continues from LIC809... At approximate 1:00pm LPA initiated a review of 3 staff and 4 resident files. All resident's files are current with their medical assessments and care plans. 3 out of 3 staff files have active CPR/first aid certificates and required training hours. Administrator Certificate for Emma Mutunga, 6003067740, expires 4/18/2025. At approximate 2:00pm LPA/Licensee conducted spot check of medications and found resident's (R1) medications were not current into the Centrally Stored Medication. Licensee agreed to review and update the Centrally Stored Medication Records. LPA requested updates of the following forms by 12/15/2023: LIC500 - Personnel Report, LIC308 Designated Administrative Responsibility, copy of control of property, LIC610E - Emergency Disaster Plan and Certificate 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 was conducted with Licensee and a copy of this report was provided.