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25 | Licensing Program Analyst (LPA) Tao conducted an unannounced annual inspection visit. LPA met Tracy Martin, Licensee/administrator and the purpose of today's visit was discussed. The facility was licensed to serve elderly, ages 60 years old and older and had two (2) approved hospice waiver. The facility capacity was five (5) including three (3) ambulatory, two (2) non- ambulatory and zero (0) bedridden. The facility had dementia program in place. Annual fees are current.
For today’s visit, CARE tool was used, administrator was interviewed, physical plant was conducted, and food supply/facility files were reviewed. No resident was interviewed as resident census was 0.
The facility is a two-story house with four (4) resident bedrooms, one (1) staff bedroom, four (4) bathrooms, living room, kitchen, dining room, family room, backyard with patio, activity area in the garage, and laundry room. The resident bedrooms were accommodated with the resident’s furnishings and in compliance. Bathrooms are furnished with grab bars and nonskid surfaces. Common areas and outdoor areas are observed for the ability to safely serve the needs of the residents. Hot water temperature was 114.5 degrees Fahrenheit which was within Title 22 Regulation guidelines. Exits’ auditory devices were operable. Medication box was centrally stored in a locked medication cabinet and inaccessible to residents. Sufficient of linen supplies and personal hygiene supplies were observed. Sufficient supply of perishable and non-perishable foods was observed. Kitchen appliances were observed to be cleaned. Smoke detectors and carbon monoxide detectors were tested and operable. Fire extinguishers were fully charged.
No deficiency was cited per California Code of Regulations, Title 22. An exit interview was conducted. This report is discussed and provided to Licensee Tracy.
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