Routine inspection·July 23, 2024

Licensing Program Analyst (LPA) Alviso conducted a Required- 1 Year visit and met with Licensee/ Administrator Liza Biscocho. LPA observed two (2) caregivers on duty, Charles and Jittraporn (Nettie). Facility has five (5) residents in care; One (1) resident is receiving hospice services. Facility has an approved hospice waiver for three (3) residents. Facility has an approved dementia plan of operation. Facility has an emergency disaster and evacuation plan as required. Facility has an infection control plan as required. Fire clearance is approved for six (6) non-ambulatory, of which one(1) may be bedridden. LPA reviewed five (5) resident files. Medication records and storage of medications were checked. All medications were locked and inaccessible to residents in care. LPA reviewed three (3) staff files. All staff have required criminal record clearance. Staff have required training. Staff have first aid certification and cpr certification as required. Facility has emergency drills quarterly as required, per record reviews. LPA toured the facility with Administrator. Hot water was checked at 110. degrees Fahrenheit. All exits were free and clear of obstruction. All exit doors had auditory alarms. Fire extinguishers, two (2), were showing fully charged, were inspected and tagged. Smoke alarms are hard wired, and is also a carbon monoxide detector. Food supply was sufficient. All medications were locked and inaccessible to residents in care. All cleaners/disinfectants were locked and inaccessible to residents in care. Facility was clean and orderly. Facility had a sufficient supply of personal protective equipment (PPE), paper products, hygiene products, linens, and furnishings for resident use. LPA is requesting the following documents be updated and submitted by 8/23/24: LIC500 - Personnel Report LIC610E-Emergency Disaster Plan (ensure to review and update as needed/required- if no changes submit last page with date/signature of review) Infection Control Plan (ensure to review and update as needed/required- if no changes submit last page with date/signature of review) Copy of LIC400 Handling of Client Cash Resources (include copy of surety bond if handling cash) Copy of Current Liability Insurance Resident Roster No deficiencies cited today.