Routine inspection·August 17, 2022

Licensing Program Analyst (LPA) Arielle Pascua conducted an unannounced visit on this day for the purpose of conducting a 1-Year Annual Visit. LPA Pascua arrived and was greeted by Caregiver, Cynthia Miller. LPA Pascua asked Caregiver, Miller to contact the Facility Designated Administrator (FDA) to let them know that CCL was present at this time. FDA Cosmina Stancu arrived shortly after LPA Pascua's arrival. This facility is licensed to serve and accept up to 6 residents who are deemed to be non-ambulatory only. . Administrator holds a current certificate and expires on, 01/25/2023. Current Census was 2. Tour of the facility was conducted. Fire extinguisher located in the kitchen was purchased on 02/07/2022. Dining areas, living areas, and all other areas intended for resident use were toured. It was observed that furniture and furnishings were sufficient and able to meet the needs of the residents at this time. Kitchen area was toured. Food storage units were reviewed for adequate 2-day perishable and 7-day non perishable quantities at this time. Knives were locked and made inaccessible to the residents at this time. LPA Pascua observed a locked centralized stored medication cabinet located in the kitchen. Along with the administrator, the LPA observed, reviewed, and compared resident medication and medication dispensing logs. First Aid Kit was present and contained all of the required components. A linen closet was located in the hallway and presented a sufficient amount of linens to adequately supply and meet the needs of the residents at this time. Laundry area was toured. Laundry detergent, bleach, and all other cleaning supplies were observed to be locked and made inaccessible to the residents at this time. A tour of the bedrooms was conducted. Resident furniture was observed to be sufficient to meet resident needs at this time. A tour of the bathrooms was conducted. Hot water temperature was measured and observed to be within the required range of 105-120 degrees. The exterior of the physical plant was in good repair with no hazards present. Perimeter fence was observed to be stable and gates were in good repair The following forms and documents were requested to be updated and submitted into CCL. -LIC 308 -LIC 400 -LIC 500 -LIC 610 The following deficiencies were observed and cited on the following LIC 809-D pursuant to Title 22 Rules and Regulations, Health and Safety Code. Appeal rights were printed and a copy was given to the facility designated Administrator. Exit Interview