Routine inspection·March 1, 2023

Unannounced annual visit made out to this facility on 03/01/2023 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility designated Administrator Cleofe Malonzo who was briefly interviewed. It was learned that this facility accepted and retained elderly residents, age range 60 years of age and older, at this time. This facility is also vendorized through Valley Mountain Regional Center to accept and retain Level 4F, and higher, residents at this time. Current census was 4 residents. Tour of this facility was conducted. Dining area, living 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 front resident bedroom was conducted. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. A tour of the resident restroom was conducted. Hot water temperature was taken and measured to make sure that it was within the allowed range of 105-120 degrees. Fire extinguisher, located hanging in the kitchen area, was observed to have been annually purchased on 03/17/2022 from the local Costco store and in compliance at this time. Kitchen area was toured. Cabinets and drawers were reviewed. Food supply was reviewed to make sure that there was an adequate supply of 2-day perishable and 7-day nonperishable quantities at all times. Medication cart, located in the kitchen area, was observed to be locked and made inaccessible to the residents at this time. A brief review of the medications and dispensing policies and procedures were discussed with the facility designated Administrator at this time. First aid kit, located in a medication cart, was observed to be present and contained all of the required components at this time. A tour of the resident bedrooms was conducted. Resident bedroom furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. A tour of the resident restrooms was conducted. Linen closet, located in facility hallway leading to the resident bedrooms, was observed to be supplied with a sufficient supply of blankets, towels, and bedspreads at this time. Laundry area was toured. It was learned that there were other cabinets used in the garage area that were locked to make cleaning and laundry supplies inaccessible to the residents at this time. Garage area was toured. Exterior grounds of this facility was reviewed. A review of the facility perimeter fence, side gates, and exits was conducted. The following forms and documents were requested to be updated and submitted into CCL: LIC 308 LIC 400 LIC 500 LIC 610 There were no deficiencies observed or cited during today's annual visit. Exit Interview