Facility Evaluation Report

On April 16, 2025 Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. LPA met with caregiver, Renato Pera and explained the purpose of the visit. The administrator arrived and assisted with the rest of the inspection.

LPA toured the facility inside out and inspected the living room, dining area, kitchen, bedrooms, bathrooms, garage, side yard and backyard. The facility has 5 resident rooms (one shared room) and 1 staff room. Food supplies were sufficient of 2- days perishables and 7- days of non-perishables. Lamp and lights were present in all rooms and hallways. Toilet, hand washing and bathing areas were observed clean and in operating condition. Showers were observed equipped with non-skid mats and grab bars. Central storage for medications was locked.

Hot water temperature in the kitchen and bathroom were measured at 130-160 degrees Fahrenheit. Fire extinguisher checked and last inspected on October 4, 2024.

Sharps, chemical and toxins were observed to be locked and inaccessible to residents in care.

A review of (4) resident files was conducted and noted on the LIC 858.

A review of (2) staff files was conducted and noted on the LIC 859.

The following documents were requested submitted to CCL by 4/18/2025:

- liability insurance; control property, and administrator certification.

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 additional civil penalties.

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