Routine inspection·June 30, 2025

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced to conduct a required annual visit. Upon arrival, the LPA met with staff and explained the reason for the visit. The Administrator was unavailable during today’s visit, but designated staff to sign report. Entrance interview conducted. Starting at 09:50am, the LPA along with 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. The following was observed: KITCHEN: The LPA inspected the kitchen/food service area at 10:05am. Knives and sharps were observed in a locked drawer inaccessible to residents in care. Cleaning supplies were kept locked and inaccessible under the kitchen sink at the time of the visit. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Refrigerator and food pantry were checked for proper labels and expiration dates. Hot water temperature was checked in kitchen faucet, and it measured 113.00 degrees Fahrenheit. COMMON AREAS: At the time of the visit, furniture in the common areas was observed to be in good condition. The facility maintained a comfortable temperature. The LPA observed the fire extinguisher to be fully charged with a date of 06/15/2025. Report Continued on LIC 809C... Report Continued from LIC 809... Required postings were observed throughout the common space. The LPA observed a fireplace adequately covered at the time of the visit. Activities were observed in the living room. There is a working telephone on premises. The LPA observed a closet in the hallway with additional clean linens and towels. Auditory alarms were observed at the time of the visit. The LPA observed an adequate supply of emergency food and water. At 10:12am, the smoke detectors and fire door were tested and operational at the time of the visit. No obstructions or hazards observed inside or out. LAUNDRY ROOM: There is a laundry room with a washer and dryer. Laundry detergents and toxins were observed locked and inaccessible at the time of the visit. RESTROOMS: There are two (2) restrooms for resident use. One (1) bathroom is located by the main hallway and the second bathroom is located inside bedroom #2. Bathrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels. Personal hygiene items were also observed locked under the sink at the time of the visit. Starting at 09:55am, the hot water temperature was measured in bathrooms, and they measured within the required range of 105 – 120 degrees Fahrenheit at the time of the inspection. BEDROOMS: There are four (4) bedrooms for resident use. Two (2) bedrooms are designated for double occupancy and two (2) bedrooms are designated for private / single occupancy. All resident rooms were observed to be furnished appropriately with linens, appropriate furnishings, and sufficient lighting. Bedrooms #1, #2, and #3 were observed to have access to the outside perimeter. The LPA observed a staff room on premises which was inaccessible to residents in care at the time of the inspection. Report Continued on LIC 809C... Report Continued from LIC 809C... OUTDOORS / BACKYARD: The backyard was observed with a shaded area with appropriate furniture for resident use. There are two (2) side gates that self-latch. All passageways were observed to be clear of any obstructions. No bodies of water noted at the time of the visit. RECORDS: The LPA reviewed Resident Records and Personnel Records starting at 10:20am. Five (5) resident files were reviewed for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, preplacement appraisals, consent for treatment form, and current needs and services plan. Three (3) personnel files were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate yearly training. During record review, it was revealed that facility does not have a staff training binder; therefore, LPA was unable to verify yearly training. Additionally, staff on premises do not have current first aid/cpr training. Staff stated they will complete training by today. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today’s visit, the LPA reviewed the facility's infection control plan. The facility’s policies and procedures as it pertains to infection control are adequate. Emergency disaster drills conducted quarterly as per regulation; most current drill conducted on 05/03/2025. MEDICATIONS: Medications review began at approximately 12:15pm. Medications are centrally stored in a locked closet by the main hallway. First Aid Kit and manual were observed and complete at time of the visit. Medications appeared to be given as prescribed at the time of the visit. Pursuant to Title 22 of the California Code of Regulations Division 6, Chapter 8, the following deficiencies were cited (refer to LIC 809-D). Failure to correct the deficiencies may result in additional civil penalties. Exit interview conducted. A copy of the report and appeal rights were provided.