Routine inspection·July 29, 2025

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a required Annual inspection and was greeted by caregiver. Administrator Helen Trinidad Administrator Certificate 7002182740 expires 8/26/25. LPA and Administrator discussed facility's Infection Control Plan and Emergency Disaster plan. No new updates. At approximately 9:30am LPA 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. Closet off of kitchen found to have rodent droppings ( 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. One resident bathroom did not have a required bath mat but did have grab bars, the other resident shower did have required bath mat. Water temperature in sink accessible to residents in care measured at 122.7 degrees F in the common hall bathroom which is not within the allowable range of 105 to 120 degrees F but measured 108.6 in the kitchen and 109.7 in room #1 which is within the allowable range of 105 to 120 degrees F. Licensee immediately turned down water heater and will continue to work on getting all temperatures within regulation. Fire extinguishers were last inspected 6/16/25. Smoke/Carbon Monoxide detectors located throughout the facility were tested and operational. Facility’s last quarterly disaster drills were conducted 6/15/25. Facility has a backup generator for use during a power outage. Continued on 809C... LPA found in the backyard several old mattresses, old portable toilet chair, pieces of plywood, and upright ladder. LPA discussed with Admin being sure to dispose of old or no longer used items in a timely manner and to properly store hazards such as the upright ladder, when not is use. Additionally, there are several planks on the wooden deck ramp that need replacing, as they are broken and/or showing signs of what appears to be dry rot as some planks are brittle and crumbly as well as having deep cracks and bubbling paint. Gate to ramp on other side of house also showing what appears to be dry rot as wood has deep cracks and is brittle and crumbly in places. Licensee is currently working on repairs. Fence on east side of facility needs repair/replacement. LPA and licensee discussed replacing the fence. Licensee advised that he is actively in discussion with neighbor to get it replaced and plans to repair by 2026 if he and the neighbor cannot reach an agreement. At approximately 11:30am LPA conducted a review of 6 resident records. All required documentation present. 1/2 rails orders all on file for respective residents. At approximately 12:30pm LPA conducted review of 4 staff records. All required documentation present. At approximately 1:00pm LPA and Admin conducted a spot check of medication and medication records. Medication is centrally stored in a locked cabinet. LPA observed top drawer on left hand side of range in kitchen to store pre-poured medications ( deficiency cited, see 809D ) Drawer has locking function but LPA found it not locked, making medications accessible to residents ( deficiency cited, see 809D ). LPA and Admin discussed ensuring PRN log/MAR is complete with all required information. 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 .