The LPA and the Administrator began the tour of the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The LPA observed required postings throughout the common space.

COMMON AREAS: Living room and dining room furniture were observed to be in good condition. There is a fireplace in the living room, which is covered with a screen and inaccessible. The facility maintained a comfortable temperature of 78 degrees. Smoke detector(s) and carbon monoxide detector were tested at 12:45 p.m. and operational at the time of the visit. The fire extinguisher observed fully charged; last serviced 5/2023. Administrator shall contact the company to have the extinguisher serviced or purchase a new one.

BEDROOMS: There are (5) five bedrooms in the facility; the facility has (4) four private bedrooms for resident use and (1) shared bedroom for resident use there is no staff room, and the facility has a den that is used as office space for staff. All resident rooms have direct access to the outside. Lighting in the rooms appeared adequate. Resident rooms were set up with beds, night stands, lamps, chests of drawers, chairs and closet space.

BATHROOMS: There are (2) two full bathrooms; one bathroom is located in Bedroom #1 and the 2^nd bathroom is located in the main hallway; showers are equipped with grab bars and nonskid mats.

KITCHEN: Knives and cleaning supplies observed to be inaccessible at the time of visit. Over the counter medication, vitamins and supplements observed accessible in kitchen cabinet. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Continued on LIC 809-C.

LAUNDRY: The laundry area is located in a room between the main hallway and den/staff office. Laundry detergent and chemicals are stored inaccessible in a cabinet above the washer and dryer. Extra linens and towels are also kept in a cabinet in the laundry room.

OUTDOOR AREA: The backyard has a covered outdoor area equipped with furniture for client use. There is a side gate for client use and is single latched. No bodies of water noted and exit is free of obstructions. LPA observed several bulky items stored in the backyard. Administrator stated it belongs to the property owner. It was agreed that the backyard will be cleared out and these items will be removed from the backyard within two weeks.

RECORDS: Resident records reviewed from approximately 1pm-2:30pm. Resident facility records observed complete. At approximately 3:30pm-5pm; Staff records reviewed observed to be incomplete, not limited to health assessments, appropriate training topics. LPA was unable to verify required training topics and hours for staff #1. Incomplete medication training. Staff #2 did not obtain fingerprint clearance and has been working at the facility since 5/2024. Civil penalties assessed.

MEDICATIONS: Medications are in a locked cabinet in the staff office. The first aid supplies and a first aid manual were stored in the medication cabinet. Medication reviewed for two (2) out of five (5) residents at approximately 5pm-5:30pm. During the review it was observed that staff are writing on the residents medication prescription labels (start dates). Administrator did not have PRN authorization letter for residents with PRN medications.

The following deficiencies were observed (See LIC 809-D.) and cited from the California Code of Regulations, Title 22 and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted. A copy of the report and appeal rights were provided.