Routine inspection·October 24, 2023

On 10/24/2023, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct an annual visit. LPA was greeted by Staff Member (SM), Farah Bailey and explained the purpose of the visit. LPA asked that SM Bailey call the Facility Designated Administrator to inform them that CCL was present. Shortly after, LPA met with Facility Designated Representative (FDR), Kenroy Anderson and explained the purpose of the visit. There was one other staff member present at the facility, Raffy Corla. Shortly later, LPA met with Licensee, Marinela Placintar. LPA reviewed 6 resident files and 3 staff files. 5 out 6 resident files did not have a complete 602, Pre-Apprasial, and Needs and Services Plan. 3 out 3 staff files were complete and up to date. It was learned that the facility does not have an administrator that does not have a current administrator certificate. A tour of the facility was conducted. A tour of the kitchen was toured. Knives were observed to be locked and made inaccessible. Food supply was observed to ensure that there was a 2 day supply of perishable food supply and 7 day non-perishable food supply. The refrigerator was observed to have a flat of eggs, 2 loafs of bread, a gallon of milk, 2 half empty containers of juice, half a bell pepper, half of a onion, and a head of lettuce. A tour of the backyard was conducted. LPA observed the cement walkway was lifted about 5 inches off the original pavement. It was observed by the LPA that there were miscellaneous items such as floss, receipts, batteries, bottle caps all throughout the fences and front of the facility. A tour of the garage was conducted. An additional regriferator unit was observed. Additional hygiene items were identified. A tour of the laundry was conducted. Toxins, laundry supplies, and other cleaning supplies were observed to be locked and made inaccessible. A tour of the resident bedrooms was conducted. LPA observed a strong smell of urine in 3 out of 4 bedrooms. Furniture and furnishings were observed to be in good repair and meet the residents needs. A tour of the bathrooms were conducted. Hot water temperature was taken to ensure compliance with Title 22 regulations. A medication cabinet was located in the kitchen. Along with the Facility Designated Representative, LPA observed, compared, and reviewed medication with medication dispensing logs. First aid kit was reviewed and had all the required components. Fire extinguisher was observed and was last serviced by Jorgenson Co on 02/27/2023 and is in compliance at this time. Smoke detectors and carbon monoxide was observed to be in working condition. The following forms and documents were requested to be updated and submitted into CCL -LIC 308 -LIC 400 -LIC 500 -LIC 610 -Liability Insurance Per California Code of Regulations (CCR) – Title 22 – Division 6, Chapter 6, deficiencies were observed during today’s visit. Citations can be found on the LIC 809 – D. Failure to correct deficiencies may result in civil penalties. Appeal Rights were provided to facility. An exit interview was held, and a copy of the report was provided in-person and sent via email.