Routine inspection·August 26, 2022

On today’s date, at 2:45PM, Licensing Program Analyst (LPA) L. Fici and Licensing Program Manager (LPM) Y. Flores-Larios arrived unannounced to conduct an Annual Infection Control Visit. LPA and LPM was greeted by Care Staff, Deogracia Concha at front door entrance. Shortly after, Licensee, Mary, Sunderraj arrived to facility. During the inspection, LPA and LPM toured facility including but not limited to front entrance, kitchen, common areas, hand washing stations, bedrooms, bathrooms, and backyard. LPA and LPM observed COVID-19 signage throughout the facility. Hand washing signs were posted at hand washing stations. LPA and LPM observed paper supplies and PPEs are sufficient. Facility has a sufficient 2-day perishable and 7-days non-perishable food supply. Common areas are disinfected frequently throughout the day. Water temperature is measured at 105.4 degrees F. Fire extinguisher was last serviced on 4/5/2021. Facilities room temperature is at 75. Carbon monoxide and smoke detector are operable. Facility passages inside and out are free of obstruction and does not pose a health and safety risk for persons in care. During record review, LPA and LPM observed facility has a copy of their Infection Control Plan on file. Continue on Lic809-C Continued on Lic809-C The following Deficiencies were observed during visit: 1. At 2:50pm, LPA and LPM observed Medication and Knives unlocked and accessible to residents in care. 2. At 2:50pm, LPA and LPM observed during record review 6 out of 6 residents that do not have appraisal needs/service plans in their file. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct the deficiencies and/or repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted with licensee, appeals rights given and copy of this report provided.