Routine inspection·December 4, 2023

Licensing Program Analyst (LPA) Elsie Campos arrived at the facility unannounced to conduct a required annual visit at 10:30 a.m. The LPA was greeted by staff and informed them of the reason for the visit. Administrator Johneil Briones arrived shortly thereafter. The LPA and Staff toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. KITCHEN: The LPA toured the kitchen/food service area. Knives and cleaning supplies are stored inaccessible. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. The hot water temperature was measured in the kitchen and measured 120.2 degrees Fahrenheit. BEDROOMS/BATHROOMS: Bedrooms were furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. At 1:42 p.m. the LPA observed accessible scissors in bedroom #3 in a drawer next to the resident’s bed. The scissors were taken out and locked with the sharps immediately upon discovery. There are five designated resident rooms and one staff room. The two resident bathrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with soap and paper towels. The hot water temperature measured at 120.1 degrees Fahrenheit in the hallway bathroom. COMMON AREAS: At the time of the visit, living room and dining room furniture was observed to be in good condition. There is a fireplace in the living room, which is screened and inaccessible. The facility maintained a comfortable temperature of 73 degrees F. Smoke detector(s) and carbon monoxide detector were tested at 1:32 p.m. and operational at the time of the visit. The two fire extinguishers were fully charged and last purchased on 12/4/23. The LPA observed required postings throughout the common space. There is a laundry room located in the main hallway and all cleaning and laundry supplies are kept locked and inaccessible. ** Continued on LIC 809-C** OUTDOOR AREA: The backyard has a covered outdoor area equipped with furniture for resident use. There is a side gate for resident exit and is single latched, all exits are free of obstructions. There is a gated pool which was locked and inaccessible at the time of the visit. There is an attached garage with an additional refrigerator with perishable and non-perishable food items. At 11:25 a.m. the LPA observed various expired dry food items such as macaroni and cheese, crackers, cereal and dry pasta. All identified items were discarded immediately. Additionally, two cartons of eggs requiring refrigeration were located outside of refrigerator and both cartons were discarded immediately. Cleaning supplies and tools are kept locked in the garage. The LPA observed an adequate supply of emergency food and water including a sufficient supply of Personal Protective Equipment (PPE). In addition the LPA observed the required generator with a generator switch in the backyard area. Due to time constraints, the LPA will return at a later date to complete the inspection. The LPA obtained the following documents: - Resident Roster - Liability Insurance The following deficiencies were observed (See LIC 809-D.) and cited from the California Code of Regulations, Title 22 and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted. A copy of the report and appeal rights were provided.