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25 | Licensing Program Analyst (LPA) Victoria Brown arrived unannounced to conduct a Required - 1 Year visit on 7/6/23 at 12:00PM. Administrator certificates expires 2/20/2025. License fees current.
LPA met with Yacub Lucas and stated the purpose of todays visit. The facility is licensed for a capacity of 6 non-ambulatory residents of which 6 may receive hospice services. LPA toured and inspected the physical plant inside and outside to ensure there are no safety hazards to residents. LPA observed residents participating in a group activity during this visit. LPA observed 2-day perishables and 7-day non-perishables.
The temperature inside the facility was observed to be at 75*F which is within the required range of 68-85*F. The hot water temperature was measured at 105.6*F which is within the required range of 105-120*F. LPA observed fire extinguisher(s), smoke and carbon monoxide detectors, and central heating and air in the facility. Facility has a pull alarm system.
LPA observed the centrally stored medications area to be locked and inaccessible to residents. The first aid kit contained the required items such as sterile dressings, bandages, adhesive tape, scissors, tweezers, thermometers, antiseptic solution and guide.
Upon a file review the following items were discussed to be submitted with any changes annually:
Designation of Facility Responsibility (LIC308)
Liability Insurance
Personnel Report (LIC500)
Administrator Certificate-Updated
Per the California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies observed or cited. Exit interview held, copy of report given |