Facility Evaluation Report

On 11/14/24 at 10:15am an unannounced annual visit was conducted by Licensing Program Analysts (LPAs) Perchui Milena Khurshudyan and Huma Rahimi . Upon arrival, LPAs met with the caregiver Jesley Lopez, who granted access to the facility. LPAs explained the reason for the visit. Shortly after the House Manager, Esmeralda Puente arrived and helped with physical plant tour and staff/residents files.

During today's visit, LPAs conducted a physical plant walk through, at approximately 11:00am, to ensure that the facility is in compliance with rules and regulations under California Code of Regulations, Title 22.

Facility is licensed for capacity of six (6) residents. There are four (4) bedrooms in the facility of which four (4) bedrooms designated for residents’ use. Bedrooms are appropriately furnished and have appropriate lighting. There are two (2) bathrooms in the facility. LPAs observed bathrooms have soap, paper towels and hand washing signs. The hot water temperature measured at 11:15 to be 115°F. Extra towels and linens were readily available. There are grab bars for each toilet and shower, bathrooms have non-skid mats. All trash cans in bathrooms had fitted lids to protect from cross contamination. Facility has an office space where all residents/staff files are being stored.

LPAs observed that the medication are kept in the living room in a locked cabinet and inaccessible to residents in care, however, review of R3's random medication revealed that the facility started a new bottle of Levetiracetam 500 MG (Seizure Medication), on 08/17/2024 with a quantity of sixty (60) tablets. The bottle was finished on 09/15/2024. A new bottle of the same medication was filled on 09/19/2024 with quantity of 180 tablets. LPAs observed that there was a gap/discrepancy of four days between the two bottles. LPAs asked the House Manager and the staff for explaining and both staff and the House Manager could not provide any answers.