Routine inspection·February 20, 2023

Licensing Program Analyst (LPA) Delmundo conducted an unannounced annual/infection control inspection. LPA met with staff, John Louie Neri, and informed the purpose of visit. Olive 'Lynn' Lopez Neri. administrator, arrived after about 45 minutes. Facility has an approved LIC808 Mitigation Plan. Facility has LIC9282 Infection Control Plan on file which LPA obtained copy on this day, February 20, 2023. LPA toured the facility inside out with John Louie Neri. LPA inspected the living room, dining room, kitchen, hallways, residents bedrooms, side and backyard. There's adequate food supplies of perishables good for 2 days and non-perishables good for 7 days. LPA observed screening station by the front entrance with hand sanitizer, no touch temperature probe. Facility has Visitor's log. Temperature and symptom checks are done at the entrance. Facility keeps record of proof of vaccination of residents and staff. Supplies of PPEs checked. Facility has antigen test kits readily available. COVID-19 signages were observed throughout the facility. Bathroom lavatories were observed with liquid soap. Fire extinguisher checked, and observed fully charge with tag showed serviced June 10, 2022. Hot water temperature in the common bathroom was tested and measured at 114 degrees Fahrenheit. .......continued on 809C LPA observed the following: 1. Trash cans with no lids in residents shared bedroom and ensuite bathroom. 2. Cleaning supplies, tools, pails of paint in two unlocked storages. 3. Scissors in drawer without lock in the dining room. 4. Medications in unlocked staff bedroom. 5. Common towels and hand hand towels in two bathrooms. Adminstrator to submit the following by March 6, 2023: 1. LIC308 Designation of Facility Responsibility 2, LIC500 Personnel Report 3. LIC610E Emergency Disaster Plan (9 pages) 4. Proof of $3M liability insurance. 5. Current N95 fit testing records/certificates Deficiencies are cited from Title 22 California Code of Regulations, and listed on 809Ds. Failure to submit proof of corrections by plan of correction due dates, and any repeat violation within 12 month period may result in civil penalties. Deficiencies and plan and proof of corrections were discussed with administrator. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.