LPA Ramirez toured the interior and exterior portions of the facility with caregiver Harsan. At 9:14 AM LPA observed residents having scrambled eggs, oatmeal, coffee and milk for breakfast. The facility is a single level structure and is licensed for six non-ambulatory residents, of which six may be on hospice and zero bedridden. There are a total of seven bedrooms, of which six are resident bedrooms and one staff bedroom. Each resident bedroom has their own private bathroom. There are a two full restrooms for staff. LPA Ramirez toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. Restrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature tested between 114.0-114.4 degrees Fahrenheit.

Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to residents in care. Fire extinguisher was charged, mounted and located by the dining room.

CONTINUED ON LIC809-C..

For the exterior portion, LPA Ramirez observed a shaded area, patio furniture, and the grounds were free of any hazards. There are two gates in the backyard, which both are self-closing and self-latching. No bodies of water were observed.

LPA reviewed six resident files and two staff files. LPA interviewed residents and staff present.

For today's visit no deficiencies were issued per Title 22 Division 6 of the California Code of Regulations.

An exit interview was conducted with AD Mesdjian.

A copy of this report was provided at the time of exit.