Routine inspection·February 29, 2024

Licensing Program Analyst (LPA) Alviso, conducted a Required- 1 Year inspection, at about 2:05pm on 2/29/24, and met with Barbara Santos, caregiver. Caregiver contacted the Licensees/Administrators Joy and Manuel Ortega, who arrived a short time later. The facility has six (6) residents in care. Facility has an approved dementia plan of operation. There is an approved hospice waiver for four (4) residents. Fire clearance is approved for six (6) non-ambulatory, which includes one bedridden clearance (RM #6.) Fire extinguishers, two (3), were serviced and tagged as required, expires 12/6/24. Facility has a required emergency disaster plan. Facility has a required infection control plan. LPA reviewed six (6) resident files; All resident files were complete. LPA reviewed six (6) staff files. All staff have criminal record clearance as required. All staff had current First Aid and CPR as required. All staff had required annual training completed. LPA toured the facility with the Administrator. The home was clean and orderly. Hot water was checked at 111. degrees Fahrenheit All exits were clear. All common areas, hallways, bathrooms, and resident rooms had sufficient lighting for resident use. Facility had a sufficient supply of perishable and nonperishable food. Facility had a sufficient supply of hygiene products, paper products, and cleaning supplies. Medications were locked and inaccessible to residents in care. Toxins were locked and inaccessible to residents in care. Bathrooms had grab bars and non-slip mat for resident use. The facility has supplies to meet the 72 hour shelter in place requirement. Continued on LIC809C... LPA is requesting the following documents be updated and submitted by 3/27/24: LIC308 - Designation of Administrator Responsibility LIC500 - Personnel Report LIC610E-Emergency Disaster Plan- review and submit (provide all information in all boxes as required) Infection Control Plan- review and submit (provide all information as required) Copy of LIC400 Handling of Client Cash Resources (complete the form even if not handling cash) Copy of required Surety Bond (if handling cash) Copy of Current required Liability Insurance Copy of current Administrator Certificate There are no deficiencies cited during today's inspection.