Facility Evaluation Report

On 10/23/2024, Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. LPA met with the administrator, Lilibeth Letrondo and explained the purpose of today's visit. House Manager, Veronica Cochon arrived shortly thereafter.

The facility is licensed for a capacity of 4 non-ambulatory residents of which 1 may receive hospice care services. Current census is 3 residents.

There were no residents under the care of hospice at this time.

LPA toured the facility inside and outside including the 4 private bedrooms, 2 full- bathrooms, kitchen, living room and common areas. The facility observed to clean, tidy and in good repair. Bedrooms were equipped with the required furniture for residents to use. Bathrooms are equipped with grab bars, and in good condition. Facility temperature is comfortable. Hot water temperatures in the kitchen and bathroom was measured at 109- 115 degrees F. LPA observed 2-day perishables and 7-day non-perishables. Facility exits have audible devices installed.

Laundry room, located in the garage area, was observed to be locked.

Linen closet was reviewed. Bed sheets, linens, and towels were observed to be sufficient and able to meet the needs of the residents at this time.

LPA observed a pull alarm system, fire extinguisher(s), smoke and carbon monoxide detectors in the facility. Fire extinguishers were last inspected on 9/19/2024.

Central stored medication, toxins and sharps objects were observed to be locked and inaccessible to residents.

P& I were reviewed for 3 clients and LPA observed Records Of Client's/Resident's Safeguarded Cash Resources was incomplete as the column for Signature for Cash Transitions were not signed by the clients, or their responsible parties.

A review of (3) resident files was conducted and noted on the LIC 858.

A review of (3) staff files was conducted and noted on the LIC 859

Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties.

This report is reviewed and discussed with the administrator. A copy is provided and the appeal rights.