Routine inspection·September 29, 2022

Licensing Program Analysts (LPA) Sarah Hurt conducted an unannounced visit today for the facility’s annual inspection. LPA met with facility staff Rainileo Clavana Continual Administrator's Certification for Voica Matis expires 12/16/2023. There are currently 5 residents who reside at this home and there is 0 residents on hospice at this time. LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, activity rooms, medication storage, kitchen, garage and outdoor areas. Bedrooms were clean and in good repair. Food supply is adequate for 2-day perishable and 7-day nonperishable. Fire extinguisher is within the safety regulation period. Smoke alarms were tested and are operational. The home has a carbon monoxide detector and performs disaster drills as required. Water temperature was tested at 119 degrees. First Aid kit is on site and complete. LPA confirmed staff present has a COVID 19 vaccine card or exemption card on file. LPA confirmed all staff present to be background cleared. LPA observed cleaning solutions such as glass cleaner, and Fabuloso not secured or locked in the facility garage area. LPA observed a closet used to store facility medications unlocked and accessible to residents. There following deficiencies observed or cited during today's inspection per California Code of Regulations, Title 22. LPA's requested the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing. Exit interview conducted with facility staff Rainileo Clavana and copy of report left at facility