Routine inspection·May 20, 2022

Licensing Program Analysts (LPAs) Charlie Yang and Arielle Pascua conducted an unannounced Annual on 05/20/2022. LPAs met with the Facility Designated Administrator, Johanna West. There was one staff member present at this time, Tammy Hughes. This facility does not have a dementia program or hospice waivers. Current capacity was full at 6. A tour of this facility was conducted. The interior of the physical plant was in good condition and sanitary. Fire extinguishers appeared to have been annually inspected and was valid until 06/01/2022. The kitchen area was toured. LPAs observed a sufficient seven days of non-perishable foods as well as two days worth of perishable food supplies in the main kitchen. Soap, cleaning supplies, and knives were locked. Additional perishable and non-perishable food supplies were identified in the garage. LPAs observed a locked centralized stored medication cabinet. The LPAs reviewed medication dispensing logs. First Aid Kit was present and contained all of the required components. A tour the bedrooms was conducted. Resident furniture was observed to be sufficient to meet their needs at this time. A tour of the resident bathrooms was conducted. No soap or cleaning supplies were stored under the sinks. Hot water temperature was within the required range of 105-120 degrees. Grab bars were present and stable. 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. Common areas were toured. Living room, dining area and all other areas intended for resident use were observed to be furnished and maintained in compliance at this time. A tour of the exterior physical plant was conducted. Perimeter fence, side gates, and exits was inspected. The following forms and documents were requested to be updated and submitted into CCL: -LIC 308 -LIC 309 -LIC 400 -LIC 402 -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.