Routine inspection·August 1, 2024

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a required Annual inspection and was greeted by Administrator Helen Trinidad. Facility contact information was reviewed. At approximately 9:30am LPA and Admin toured the building and grounds. The facility was found to be clean and at a comfortable temperature. 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 cabinet containing cleaning supplies was locked. Kitchen drawer with sharp knives locked. 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 bathroom had required bath mat and grab bar. Water temperature in sink accessible to residents in care measured at 106.8 degrees F which is not within the allowable range of 105 to 120 degrees. Fire extinguishers were last inspected 7/23/2024. Smoke/Carbon Monoxide detectors located throughout the facility were operational. Facility’s last quarterly disaster drills were conducted on 6/11/2024. Facility has a backup generator for use during a power outage. At approximately 11:30am LPA conducted review of 5 staff records. All required documentation present. S1 was found to be residing in the facility, but not working. Per record review, S1 was fingerprinted and their clearance is "in process." Per Guardian website reason for in process status is listed as #5, which is coded as a DOJ delay. LPA advised Admin that until fingerprint clearance is granted and shows as Eligible-Clearance, S1 may not reside at or work in the facility ( deficiency cited, see 809D ). S1 left the facility while LPA present. Continued on 809C... Continued from 809... At approximately 12:30am LPA conducted a review of 6 resident records. All required documentation present. 1/2 rails all on file for respective residents. At approximately 1:00pm LPA and Admin conducted a spot check of medication and medication records. Medication is centrally stored in a locked cabinet. No deficiencies Helen Trinidad Administrator Certificate 7002182740 expires 8/26/2025. All fees are current as of this time. LPA and Administrator discussed facility's Infection Control Plan and Emergency Disaster plan. No new updates. 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 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 Licensee. 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 .