Routine inspection·June 10, 2022

On 06/10/2022 at 12:00pm, Licensing Program Analyst (LPA) L. Fici & C. Lin arrived unannounced to conduct an annual Infection Control Inspection. LPAs met with back up Administrator (ADM), Agmata Warlita and explained the purpose of the visit. LPAs toured facility with including but not limited to front entrance, screening station, hand washing stations, bedrooms, common areas, kitchen, and backyard. Facility has a sufficient 2-day perishable and one week non-perishable food supply. There is one central entry point for universal screening for staff, residents, and visitors. A sign-in policy, thermometer and hand sanitizer were observed at screening station. Cough/sneeze etiquette, social distancing and hand washing posters were observed. Common touched surfaces are disinfected at least once daily. Bathrooms are equipped with liquid soap, paper towel and trash bins with touchless lids. Facility staff were observed to be wearing proper PPE. Facility has a 30-day supply of PPEs maintained at central location and easily accessible for staff. Fire extinguisher was observed serviced 10/22/2021. LPAs observed facility passages inside and out free of obstruction. Continue on LIC809C Continued on Lic809C The following deficiency was observed: 1:00pm- LPAs observed flies coming out from under the sink; approximately 15 flies or more. 1:03pm- LPAs observed 2 knifes and scissors in the kitchen cabinet unlocked and accessible to residents. 1:05pm- LPAs observed cleaning Tide detergent on top of the washer machine in the garage. 1:10pm- LPAs observed R1 with half bed rail, and with no physicians order. 1:25pm- LPAs observed a shed in the back yard where administrator told LPAs S1 sleeps in there. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties . Exit interview conducted with ADM Report provided along with appeal rights.