Facility Evaluation Report

On 4/11/2025 at 10:45AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with caregiver, Maria Zavala and explained the purpose of the visit. Administrator, Manali Khatu arrived a couple hours later.

LPA toured the facility including but not limited to bedrooms, bathrooms, dining area, kitchen, and outdoor area. Smoke and carbon monoxide combination detectors were observed. Fire extinguishers were observed to be full and purchased on 3/20/2025. One week supply of nonperishable and 2-day supply of perishable foods were available. Hot water was measured at 107.2 degrees F in the hallway bathroom. LPA observed grab bars and non-skid mat in the bathrooms. First Aid kit is complete. LPA reviewed 6 residents and 4 staff files starting at 11:45AM. LPA reviewed a sample of resident's medications during inspection. LPA interviewed 2 residents and 2 staff.

At 11:00AM, LPA observed unlocked knives in the kitchen drawer, unlocked cleaning supplies in the laundry area, and unlocked gardening tools in the backyard. Staff locked up all the items during inspection.

At 11:10AM, LPA observed unlocked medications in the refrigerator.

At 11:20AM, LPA observed window screen was broken in the hall bathroom near the kitchen. Outdoor area have lots of beds, wheelchairs, and other items that need to be put in storage or called for bulky pick up.

The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted with Manali Khatu. A copy of this report, civil penalties, and appeal rights were provided.