Routine inspection·June 22, 2022

An unannounced annual visit was conducted by Licensing Program Analysts (LPAs) Charlie Yang and Arielle Pascua. LPAs met with caregiver, Colin Falconer, who was asked to call the facility designated administrator at the time. LPAs met with Kenroy Anderson shortly after. One other staff member was present, Nadia Falconer. LPAs met with the Licensee shortly after, Marinela Placintar. This facility has a hospice waiver for 6 and a dementia program on file. The current census was 6 residents. 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 by Jorgenson Co on 03/22/2022. The kitchen area was toured. LPAs observed a non-perishable and perishable foods in the cabinets and refrigerator. Additional perishable food supplies were identified in the garage. LPAs observed a locked centralized stored medication cabinet located in the kitchen. Along with the administrator, the LPAs observed, reviewed, and compared resident medication and medication dispensing logs. First Aid Kit was present and contained all of the required components. A tour of the bathrooms was conducted. Hot water temperature was measured and observed to be within the required range of 105-120 degrees. 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. A tour of the bedrooms was conducted. Resident furniture was observed to be sufficient to meet their needs 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. 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 garage was conducted. Additional perishable food supplies were identified. The exterior of the physical plant was toured. 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.