Routine inspection·March 7, 2022

On 3/7/2022 at 11:30AM, Licensing Program Analysts (LPAs) L. Ibo & L. Fici conducted an infection control annual inspection and explained the purpose of the visit with S2. Administrator arrived at the facility around 12:50PM. LPAs observed 5 residents during the visit. Facility has a completed mitigation plan. LPAs inspected the facility inside and outside. LPAs observed COVID-19 signage posted in common areas to promote hand washing, cough/sneeze etiquette and physical distancing. LPAs inspected the facility inside and out including but not limited to bedrooms, bathrooms, dining room, kitchen, living room and outdoor area. The facility’s temperature was maintained at 73 degrees Fahrenheit (F). Bathroom have grab bars and non-skid mat. The facility has appropriate lighting throughout. Extra linens and towels were observed in the hallway closet. Infection control designated leader is the Administrator. There was at least 7 days of nonperishable and 2 days of perishable foods. A certified administrator is on site a minimum of 20 hours a week to oversee proper business operation. Smoke and Carbon monoxide detectors were operational. Continued on next page LIC 809-C LPAs observed the following: · Facility DOES NOT document daily COVID-19 symptom checks, and any change in condition for staff and residents in order to track spread and why facility took certain steps to prevent and mitigate spread in the facility. (technical assistance provided) · Facility has NOT conducted staff training on infection prevention, symptoms, transmission and PPE use. · Unlock medications (see LIC809D) · Unlock cleaning product (comet) under the kitchen sink (see Lic809D) · Lock side exit gate (see Lic809D) Civil penalty was assessed during the visit. Deficiencies are cited from Title 22 California Code of Regulations (see 809D). Failure to submit proof of corrections by plan of correction due dates, and any repeat violations within 12-month period may result in civil penalties. Deficiencies and plan and proof of corrections were discussed with Belen Rodriguez Exit interview conducted and a copy of this report and appeal rights provided.