Facility Evaluation Report, 01/30/2024 — Schlosser Home, San Jose CA

The purpose of this case management is to amend the annual required inspection conducted on 1/28/2024 wherein the Department discussed with licensee/administrator (LIC/ADM) the deficiencies. Due to time constraint LIC 809-D was not issued. Today 1/30/2024 LIC 809-D is being issued and LIC 809-C page 2 of the annual required visit is amended. Copies of the amended and LIC 809-D are provided to LIC/ADM.

On 1/27/2024, LPA observed the following deficiencies:

1. 80087 (g)(1) - knives, opened cleaning solutions and laundry detergents are not locked and pose danger if readily available to clients.

2. 85065.5 (a)(1)(2) - the day staff ratio is not met following minimum staffing of no less than one direct care staff to three clients.

3. 85064.3(e) - licensee did not have a current administrator certificate. Licensee stated her administrator certificate expired in year 2000.

4. 80063 (a) - licensee lacked the general supervision of the licensed facility concerning the operation and hiring qualified administrator and care staff

5. 80019 (e) - licensee did not obtain fingerprint clearance for 2 adult family member residing in the facility. LPA informed licensee that Civil Penalties will be assessed for the two adult individuals. Family member has to leave the facility until fingerprint clears.

6. 80061(e)(4) - licensee did not notify the department of changes when administrator ended employment on 12/1/2023.

7. Advisory was given for expired fire extinguisher inspection, the flower pot obstructing emergency exit was immediately corrected by the licensee during the visit in keeping with the facility's emergency and disaster plan. Additional advisory for record keeping and filing was also given.

Technical advisory were provided for expired fire extinguisher inspection tag, flower pot obstructing emergency exit door which licensee corrected during the visit in keeping with the facility's emergency and disaster plan, record keeping and filing.

LPA conducted exit interview and Appeal Rights was provided to the LIC/ADM Shirley Schlosser.