Narra Tree, Inc. - Jeffrey Home

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Elena Mallett conducted an unannounced annual inspection of the facility. LPA arrived and met House Manager Madalisay. The purpose of today’s visit was explained. The facility is licensed to serve 6 elderly , non-ambulatory residents ages 60 and above. The facility is a single-story home located in a residential area in Cerritos, Ca. A tour of the facility includes: living room, kitchen, dining area, 4 bedrooms (2 double and 2 single), 2 bathrooms (1 bathroom located in client room), front yard, back yard, attached garage with laundry. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today’s visit and the initial visit and observed the following: Infection Control: The facility staff are using appropriate hand hygiene and gloves while assisting residents’ medications. Staff are cleaning and disinfecting throughout the day. Facility has sufficient PPE supplies and has an Infection Control Plan maintained at the facility and a designated Infection Control Lead. Operational Requirements: The facility has an approved fire clearance, there is a plan of operation with required Infection Control Plan and facility maintains the required current liability insurance. Physical Plant & Environment Safety: LPA toured facility. The facility is well maintained and walkways and hallways are free of debris and obstruction. Residents’ bedrooms were checked and closet/drawer space to accommodate each resident comfortably was available. The required furnishings, light and bed linens were observed. There were extra linens and towels present. The backyard is free of debris/hazards and the outdoor and indoor passageways are free of obstruction. No bodies of water were observed at the facility. A shaded table and chairs were present to allow the residents to enjoy the outdoors. There are no security bars or weapons on the premises. Hygiene products are readily available for clients. The hot water temperature was measured in both bathrooms and was measured within Title 22 requirements of 105 degrees F- 120 degrees F for both bathrooms. All storage areas for cleaning solutions, toxins, knives, sharps and hazardous items are kept locked and are inaccessible to residents. Smoke detectors are present in each resident room and the living room. All were observed to be operable. A carbon monoxide detector was present and operable. There was a fire extinguisher present that was observed to be fully charged. Staffing: There appears to be sufficient staffing at all times in the facility. The night staff that is trained and able to assist in care and supervision of the residents in the case of an emergency. Personnel Records-Training: Staff files are kept in a secure location. LPA reviewed 5 staff files. Files were reviewed for Criminal Record Clearance, Health Screening, Current First Aid and CPR as well as initial and ongoing training for care of the Elderly. Administrator’s certificate is current. Resident Records Resident records were kept in secure location and were reviewed for the following documents - Pre-admission appraisal/Appraisal Needs & Services Plan, Medical Consent, Admission Agreements, Identification & Emergency Information and current Physician's Report. LPA reviewed 4 resident files and no issues were observed. Residents Rights-Information: Residents are provided with telephone and internet at the facility. All the required postings were observed. Planned Activities: Facility offers activities like coloring and chair exercises and a central TV viewing area for residents to enjoy together. There is an outdoor furnished patio area available for the residents. Residents are taken outside for walks. Food Service: The kitchen was observed for the ability to prepare and serve food. LPA observed an appropriate food supply of two (2) days of perishables and one week (7 days) of non-perishables. Food was stored separately from cleaners, toxins and poisons. Appliances were observed to be operable and able to properly store and prepare food. A deficiency was noted. See 809-D. Incidental Medical & Dental: Medication is properly labeled and are centrally stored in a locked closet and are in their original containers. LPA reviewed 4 residents’ medications and there were no issues observed. Incidental Medical & Dental: Medication is properly labeled and are centrally stored in a locked closet and are in their original containers. LPA reviewed 2 residents’ medications and there were no issues observed. Disaster Preparedness: The facility has an Emergency Disaster Plan with contact numbers and at least 2 relocation sites. Emergency food and water were observed. A full First Aid kit and Manual were available. Last disaster drill was conducted on 03/03/26. Residents with Special Health Needs: Residents at this facility that require the use of bed rails have the required doctor’s approval. Facility has recommended documents on residents with home health services and have ongoing communication with home health agencies. Per California Code of Regulations, Title 22, and California Health and Safety Code, no deficiencies were observed during today’s visit. Exit interview was held with House Manager Madalisay and a copy of this Licensing report was provided.the state’s words, verbatim · CDSS document, Mar 13, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Cynthia Chan conducted the unannounced annual inspection on 2/21/25. LPA met with Staff, Victoria Tayag, and explained the reason for the visit. The house manager, Dalisay Lazo, arrived shortly to assist with the visit. The facility is licensed to serve six (6) non-ambulatory developmentally disabled individuals, ages 60 and over. There is an approved hospice waiver for 1 resident. The facility is vendorized by the Harbor Regional Center and there are currently 3 residents residing at the facility. LPA inspected the facility using the Compliance and Regulatory Enforcement (CARE) tools. The facility consists of 4 resident bedrooms, 1 staff office, 2 bathrooms, living room, family room, kitchen, and attached garage. There are no swimming pool or bodies of water on premises. Facility has the infection control plan and staff are continuing to clean and disinfect daily. Knives and cleaning products are locked. Sufficient food supplies of perishable and non-perishable are observed. There are operable smoke detectors and a carbon monoxide detector at the facility. The hot water temperature was measured within the required range of 105-120 degrees F. Medications are centrally stored and locked inside a cabinet. Staff and Residents files are stored and maintained at the facility. LPA reviewed 3 resident medications and they are being administered as prescribed. LPA reviewed resident and staff files to ensure all required forms are in their files. The staff and resident files contain all the required forms. The administrator's (Maria Santos) certificate expires on 4/27/25. Staff have current CPR and First Aid certificates. Staff are receiving on-going training. The facility accepts and retains residents with dementia and/or hospice. Emergency Disaster Plan is easily accessible and disaster drills are conducted monthly. No deficiencies are issued today. An exit interview was held and a copy of this report was given to staff Lazo.the state’s words, verbatim · CDSS document, Feb 21, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Nicol Wesley conducted an unannounced Required 1 year inspection at the facility and met with Administrator Maria Teresa Santos and explained the purpose for todays visit. The facility phone number is 562 865 4394.. The facility consist of 4 bedrooms, 2 bathrooms, 1 living room, 1 family room, dining room, office area, kitchen, back yard with shaded area, and attached garage. LPA Wesley conducted a complete tour of the facility, and observe the supply of food. Resident medications, and medication logs were reviewed. The smoke detectors/carbon monoxide detector are operable. LPA observed one fire extinguisher in the Hallway. The water temperature was tested and measured 105.3 degrees F. The last fire drill was conducted on 04/02/24. LPA Wesley received a copy of the facility infection control plan and insurance at the time of visit. Administrators certificate for Maria Teresa Santos #6025870740 for expires on 04/27/2025. There is one deficiency cited according to the California Code of Regulations, Title 22, Division 6, appeal rights given. A copy of the LIC 809/LIC 809D was given during the exit interview.the state’s words, verbatim · CDSS document, Apr 19, 2024