Routine inspection·May 1, 2025

Licensing Program Analyst (LPA) Cuadra arrived unannounced to conduct an Annual Required Inspection and met with Administrator, Ernesto B Idang. Licensee, Josephine Blancaflor arrived later. Fees are current. Contact information was reviewed. There are residents with a diagnosis of dementia. LPA/Administrator initiated a tour of the facility at 9:00 am and made the following observations: Facility was a comfortable temperature and passageways were free from obstructions. Although, there were five empty bottles of five gallons of water, piece of furniture and other items that needed to be cleared from the backyard, items were not obstructing any exits, but needs to de discarded (technical violation issued). Resident rooms were furnished per regulation. Water temperature in resident's bathroom measured at 109.2, 109.2 & 111.9 degrees F which was within allowable range of 105 to 120 degrees F. Extra hygiene products and linens were available. Bathrooms had required bath mats and grab bars. Kitchen cabinet containing cleaning supplies was locked. Facility has at least two days of perishable and one week of non-perishable foods. Medications were centrally stored and locked. Fire extinguisher was last inspected April 2025. Facility has hardwired combination smoke/carbon monoxide detectors located throughout the facility that were tested and operational. Exit doors have auditory alert system that were functional at time of visit. Last disaster drill was conducted on April 7, 2025. Required postings were observed. Medications and medication records were reviewed. At approximate 9:15am LPA/Administrator observed storage closet located outside containing gardening tools including saw and hedge trimmer was unlocked during the inspection. Continued on LIC809C... Continued from LIC809... File review was initiated at 9:30am. Three staff files and five resident files were reviewed. Staff have required First Aid and CPR certificates. Training records reviewed. Residents have current medical assessments and care plans updated within the last 12 months. Administrator Certificate for Administrator, Ernesto B Idang expired 4/15/2025. Based on records review, Administrator submitted their documentation as of 1/27/25 and it is currently under review in the Department's pending list. However, Licensee's Administrator certificate #7035364740 is current and expires 7/14/2026. Licensee/Administrator to submitted updates of the following documents: Designation of Administrative Responsibility (LIC308), Personnel Report (LIC500), lease agreement and 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 Licensee and a copy of this report was given.