The LPA and the Administrator toured 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 following was observed:

Hardwired combination smoke and carbon monoxide detectors were tested and were functional at the time of the visit. Fire extinguishers were observed to be fully charged and purchased on 06/22/2024.

KITCHEN: Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food. All knives and cleaning supplies were observed to be locked and properly stored at the time of the visit. Adjacent to the kitchen is a locked garage. The garage was observed and contained the laundry area, as well as emergency food supply and water, and storage.

BEDROOMS: The LPA observed the resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There are 4 (four) total bedrooms for resident use; 2 (two) are shared rooms and 2 (two) are private rooms.

RESTROOMS: The LPA observed 2 (two) restrooms in the facility. 1 (one) is for resident use and 1 (one) is designated for staff use. Resident restroom was observed to be clean and sanitary and in operating condition with grab bars and non-skid surfaces. Water temperature was measured within the regulations.

COMMON SPACES: In the common areas, walls and flooring were checked for cleanliness and good condition. At the time of the visit, living room and dining room furniture was observed to be in good condition. Continues on LIC 809C...

OUTDOOR SPACE: The backyard has a covered outdoor area equipped with furniture for resident use. All exits were observed to be clear of hazards.

RECORDS: Residents’ records were reviewed for, but not limited to care plans, medical records, admissions agreement, consent forms. All records were in order. Personnel records were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were in order.

MEDICATION REVIEW: Medications are centrally stored and locked in a cabinet in the kitchen area; medications are labeled and checked for expiration dates. Medications are properly documented on the centrally stored medications and destruction record. No errors observed during the medication review. Medications for 2 (two) residents were observed. Both 2 (two) of 2 (two) residents' medications were observed to be maintained and administered in compliance with regulation.

During today's visit, LPA gathered the following items:

· LIC 500