Facility Evaluation Report

Licensing Program Analyst (LPA) Christina Valerio arrived to the facility unannounced to conduct an annual required inspection. LPA met with facility staff Kyle, and explained the purpose of the visit. LPA spoke to licensee via cell phone. At the end of the visit, LPA met with Licensee/Administrator Linda.

LPA toured the physical plant to ensure compliance with Title 22 regulations. LPA observed facility staff making breakfast. Today breakfast was a hash brown, scrambled eggs with chorizo and spinach, coffee, milk, juice, and water. Medications were observed to be locked and inaccessible to residents in care. LPA observed facility staff pass out medications to the residents in care. LPA toured the facility with facility staff Kathy. LPA observed common areas, resident bedrooms, resident bathrooms, staff areas, and outside common areas. Resident bedrooms had required furniture and furnishings. Technical Assistance was provided for the chairs. Bathrooms were observed to be in working condition. Hot water was measured at 110.8*F. The outside area of the home had areas for residents to smoke, garden, and enjoy the outside. The facility has a fenced and locked pool area. The pool does not have water and will not be used. Lunch was observed to be sandwiches, fruit, chips and drink of choice. LPA observed fire extinguishers, a fire pull alarm system, and carbon dioxide detectors to be in working condition. The last fire drill was completed on 10/01/2023.The thermostat for the facility temperature read 73*degrees F.

LPA reviewed resident, staff, and facility files. Administrator Certificate for Linda Mustin #6055825735 Expires on 03/26/24. First aid certificates were not located in the files; however, when asked by LPA, staff were able to show their cards showing an expiration of 2024. LPA observed 5 resident files. 2 resident files did not have an updated LIC 602. LPA requested the following annual documentation: LIC 500, LIC 308, LIC 610E, Administrator Certificate, Proof of Control of Property

Per California Code of Regulations (CCR) - Title 22, deficiencies were observed today. Appeal Rights Provided. An exit interview was held, and a copy of the report was provided to Licensee.