The facility is licensed to operate for six (6) nonambulatory residents and has a hospice waiver for two (2) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: five (5) resident bedrooms, one (1) Staff Bedroom, two (2) bathrooms, living area, dining area, kitchen, and an attached two car garage.

LPA Kim toured inside and outside of the physical plant with AD Curtis. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. The Resident’s rooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, Resident Room 4, Resident Room 5, and Staff Room. Bathrooms were found to be clean and operational. The water temperature measured at 136.9 degrees F bathroom 1 and 120.2 degrees F in bedroom 5 bathroom.

LPA Kim observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly.

Evaluation Report Continues on LIC 809-C

Due to time constraint a continuation of this inspection will be conducted at a later date. LPA will conduct record review of resident, medication review, emergency drill log review, smoke detector and carbon monoxide detector check, staff interviews, and resident interviews .

Deficiencies were cited during this visit as per Title 22 Division 6 Chapter 8 of the California Code of Regulations. A civil penalty was assessed during the visit.

An exit interview was conducted, and a copy of this report and appeal rights were provided to Administrator Christopher Curtis.