Routine inspection·September 1, 2023

Licensing Program Analyst (LPA) Victoria Bertozzi arrived unannounced to conduct an Annual Required inspection and met with Licensee John Ortega. LPA initiated a tour of the facility around 12:45pm and made the following observations: Facility was a comfortable temperature and passageways were free from obstructions. Facility has three residents on hospice, which is allowable per their approved hospice waiver. Resident rooms were furnished per regulation. Water temperature in bathroom used by residents measured at 117 degrees F which is within the range of 105 to 120 degrees F allowed per regulation. Extra hygiene products and linens were available. Cabinets containing cleaning supplies were locked. Facility has at least two days of perishable and one week of non-perishable foods which appeared to be of quality and stored per regulation. Medications were centrally stored and locked. Emergency food and water supplies are stored in the garage along with Personal Protective Equipment. Fire extinguishers were last serviced January 2023. Smoke and Carbon Monoxide detectors located throughout the facility were tested and operational during inspection. Most recent fire/disaster drill was conducted 7/2023. Three staff files and six resident files were reviewed. Staff have required First Aid and CPR certificates. Administrator Certificate for Administrator, Ligaya "Joy" Ortega 6015180740 expires 4/7/2024. Medications and medication records were reviewed. Training records were also reviewed. Facility provided LPA a copy of their updated lease. Continued on LIC809C Continued from LIC809 Licensee/Administrator to submit updates of the following documents by 10/01/2023: LIC 500 Personnel Summary Copy of Liability Insurance LIC 610 Emergency Disaster Plan (If changes) Infection Control Plan (If changes) No deficiencies cited during this inspection