Routine inspection·May 15, 2025

Licensing Program Analyst (LPA) Alviso conducted a Required- 1 Year visit, on 5/15/25 at approximately 2:40pm, and met with caregivers Charles and Chadaporn, Caregivers contacted Administrator Liza Biscocho and notified them of the LPA's arrival. Administrator arrived to meet with the LPA shortly after being contacted by the staff. 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. Per record reviews, last emergency disaster drills were conducted on 5/8/25 a water, electrical, and gas shut off/outage, and on 2/17/25 an evacuation drill. Fire clearance is approved for six (6) non-ambulatory, of which one(1) may be bedridden. Facility has six (6) residents in care; No hospice residents at this time. LPA reviewed six (6) resident files. Resident files were complete. LPA reviewed five (5) staff files. All staff have criminal record clearance as required. All staff have required training. All staff have first aid, and CPR certification. Facility water was measured at 120. degrees Fahrenheit, which is within regulation. All exits were free and clear of obstruction. Smoke alarms are also carbon monoxide detectors, all worked properly during the inspection. Continued on LIC809C.. Food supply was sufficient. Facility had sufficient furnishings for resident use, and all areas of the facility have sufficient lighting for residents in care. All bathrooms had grab bars, and showers had non-slip flooring/mats for resident use. Facility had a sufficient supply of linens, paper products, cleaners/soaps/disinfectants, and personal protective equipment (PPE). Facility was observed by the LPA to be clean and orderly, and at a comfortable temperature during the inspection. Facility had a supply of emergency food and water supplies to meet the "72 hour shelter in place" requirements. LPA are requesting the following documents be updated and submitted to CCL by 6/15/2025: LIC308 - Designation of Administrator Responsibility LIC500 - Personnel Report LIC610 - Emergency Disaster Plan-update if needed-submit if changes Copy of Current Liability Insurance Copy of current Administrator Certificate Copy of updated Infection Control Plan- update if needed- submit if changes Copy of current resident Roster There were no deficiencies cited today. Exit interview conducted with the Administrator Liza Biscocho.