Routine inspection·April 15, 2025

Licensing Program Analyst (LPA) Valeria Conway arrived at the facility unannounced to conduct a required annual visit at 10:10 A.M. LPA met with Licensee/Administrator Janette Villapando and explained the reason for the visit. At 10:25 A.M. LPA conducted a physical plant tour inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. Fire extinguishers are fully charged and last serviced 07/19/2024. At 11:00 A.M. the smoke detectors and carbon monoxide detectors are combined units; they were tested and functioned properly. The facility has two (2) fire doors to enhance safety and prevent the spread of fire. One in the hallway and one in room #1. LPA observed hallway fire door functioning properly. T his facility doesn’t have a staff room, facility will provide 24/7 care. KITCHEN : The LPA observed the kitchen to be clean. Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food and water. LPA conducted a review of expiration dates on product labels. The LPA observed that four (4) items were past their expiration date. Administrator discarded all four (4) items during today’s visit. Technical Violation Issued. LPA observed sharps and knives locked in a kitchen drawer. At 10:35 A.M. hot water measured at 115.6 * F. Cleaning supplies are located in separate locked cabinets with additional supplies in the locked garage. Garage/Laundry room: Inside the locked garage, LPA observed the washer and dryer, emergency water and emergency food, cleaning supplies and disinfectants. The Garage remains locked and inaccessible to the residents in care. Continued on LIC 809-C Continued from LIC-809-C Garage/Laundry room: Inside the locked garage, LPA observed the washer and dryer, emergency water and emergency food, cleaning supplies and disinfectants. The Garage remains locked and inaccessible to the residents in care. COMMON AREAS : This includes the living room and dining room areas. LPA observed common area to be clean and properly furnished at the time of the visit. The facility serves residents with dementia, the auditory alarms on the exit doors were tested and functioned properly at the time of visit. The facility maintained a comfortable temperature of 72 degrees. During the inspection, the LPA observed a hallway closet. On the upper shelves, the LPA noted an ample supply of linens. On the lower shelves, the LPA observed various bathroom items including but not limited to air freshener, Vaseline and shampoo. It was further observed that the magnetic lock intended to secure the closet was broken at the time of the visit. Facility provides sufficient space to accommodate both indoor and outdoor activities. LPA observed a working phone available for residents use whenever needed. The LPA observed the required postings in the common area and fireplace was observed adequately screened. BATHROOMS : There are two (2) bathrooms for resident use. One is located in a shared bedroom, and one is a shared bathroom located in the main hallway. Bathrooms were observed to be equipped with slip resistant surfaces and grab bars. Between 10:49 A.M. and 10:53 A.M. hot water temperature measured between 105* - 120 *F which was within the required range. BEDROOMS : There are four (4) private bedrooms and one shared bedroom. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. During the inspection, the LPA observed that Room #1, an approved bedridden room equipped with a fire-rated door, had an industrial doorstop in place, propping the door open. The administrator explained that Resident #1 prefers door to remain open, however, administrator immediately removed the doorstop during today’s visit and acknowledged that the door will remain closed at all times in compliance with fire safety requirements. Continued on LIC-809-C Continued from LIC 809-C OUTDOOR SPACE: The backyard has a covered patio area with patio furniture and the front porch is covered and equipped with furniture as well. Facility has one side gate; LPA observed the side gate to be self-closing and self-latching gate with clear passageways for emergency exit use. During the inspection the LAP observed a locked shed located in the backyard. Upon entry, LPA noted the presence parts of a bed frame, a couch and various clothing items hanging on hangers inside the shed. The LPA remined the facility administrator that, in accordance with fire safety regulations, no individual is permitted to sleep or reside in the shed. There were no bodies of water on the premises. RECORD REVIEW: Between 11:38 A.M. and 1 P.M., staff and resident records were reviewed. LPA observed Resident #1 and Resident #2 to be at risk if allowed direct access to personal grooming and hygiene items. All records were observed to be complete. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today’s visit, the LPA reviewed the facility's infection control practices and emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Emergency disaster drills are conducted quarterly, with the last drill documented on 04/08/2025. MEDICATION REVIEW: Between 1:10 P.M. and 2:30 P.M. Medications for five (5) residents were observed. All medications observed were labeled, stored, and properly documented at the time of the visit. Pursuant to Title 22, California Code of Regulations and/or CA Health and Safety Code, the following deficiencies were cited (refer to LIC 809-D.) Administrator was informed that failure to correct the deficiencies may result in civil penalties. Exit interview conducted, appeal rights discussed, and a copy of this report and appeal rights were provided.