Routine inspection·October 4, 2023

Licensing Program Analyst (LPA) Alicia Delmundo conducted an unannounced annual required inspection. LPA met with Executive Director (ED) Cayia Henry, and informed the purpose of visit. Facility is a seven story building, 2nd, 3rd, 4th and 5th floors of which houses assisted living residents. Facility has an LIC808 Mitigation Plan on file; however, Infection Control Plan on facility file was dated January 2020, and needs updating. LPA inspected the facility inside and out with ED. LPA inspected the common areas, activity rooms, kitchen, dining rooms, courtyard and back patio. Salon, housekeeping supplies room, massage/therapy rooms on the first floor were inspected. Electrical and housekeeping supplies room on other floors and laundry room were checked and observed locked. Food supplies were observed good for 7 days of non perishables and 2 days of perishables. Freezers and refrigerators temperatures are checked by kitchen staff and records kept. LPA observed the freezer and refrigerator temperatures were at -7.0 and 35 degrees Fahrenheit respectively. LPA randomly selected 8 residents rooms for inspection - 2 each on 2nd, 3rd, 4th and 5th floors. Facility has carbon monoxide and smoke detectors and observed functional. Hot water temperature in one of the resident rooms on the 2nd floor was tested and measured at 116.8 degrees Fahrenheit. Fire extinguisher in the kitchen was observed fully charge with tag showed serviced August 28, 2023. Facility has evacuation chairs on stairwells. Facility conducts disaster drills for all shifts every quarter. and records showed last conducted September 26. 2023. LPA reviewed 5 staff files, and interviewed 4 staff and 4 residents. .......continued on 809C LPA observed the following: -at 12;05 pm, blade and scissors in the drawer without lock in unlocked salon. -at 12:10 pm, professional strength glue, scissors, paint spray, fabric and vinyl adhesive spray in cabinets without lock in unlocked art room. -staff (S2) does not have First Aid certificate. -staff (S5) does not have the required 8 hours of medication training for 2022. The following updated/current documents to be submitted by October 18, 2023: 1. LIC308 Designation of Facility Responsibility 2, LIC500 Personnel Report 3. LIC610E Emergency Disaster Plan (9 pages) 4. Infection Control Plan and Monkeypox Infection Control Plan Deficiencies are cited from Title 22 California Code of Regulations and listed on 809Ds. A $250.00 civil penalty is assessed for repeat violation of section 87309(a) within 12 month period. Failure to submit proof of correction by plan of correction due date may result in additional civil penalty. Deficiencies and plan and proof of corrections were discuss with ED. Due to time constraint, LPA will come back to continue inspection. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.