Routine inspection·August 8, 2022

Licensing Program Analysts (LPA's) Ruth Wallace and Kesha Lewis arrived at this facility to conduct a unannounced Required 1 Year Annual Inspection Visit. LPA's introduced themselves to Administrator and explained the purpose of the visit. A staff member opened the gate and LPA's were screened for COVID-19 symptoms with temperature at the medication window inside the facility. LPA's and Administrator toured physical plant inside and outside. Ensuring the safety of the residents and compliance with Title 22 regulations. LPA's also conducted the infection control domain tool. The facility has a LIC 808 mitigation plan. LPA's observed the facility to have COVID-19 informational signs posted throughout the facility. The facility is able to designated and dedicated a COVID-19 bedroom, bathroom, and isolation area if needed. The hot water measured 92.6 *F for room 22, and 94.0 *F for room 32, which was not within the regulatory range of 105 - 120 degrees F. Facility has nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days. LPA's observed the centrally stored medications area, cleaning supplies, and sharps to be locked and inaccessible to clients. Resident rooms was sanitary and had the required furniture and furnishings. The facility common areas were clean and furnished. Smoke and carbon detectors were in good repair. Fire extinguishers are current and last inspected on 11/23/2022. The facility has a front porch area that can be utilized for outdoor visits. All emergency exits were clear from obstructions. LPA's reviewed four (4) staff files. All staff is fingerprint cleared and associated to the facility and staff 1, 2, & 4 do not have current First Aid or CPR certifications on file. Facility is conducting initial and continuing training as required. LPA's reviewed four (4) resident facility files, COVID-19 Plan, and survey binder. All necessary documents were in place. LPA's observed the following posted on the facility wall: Facility license, sketch, See Something Say Something poster, Ombudsman poster, Theft and Loss Policy, Resident Bill of Rights, Rights of Resident/Family Councils. LPA's requested updated copies via email to LPA Wallace by August 15, 2022: LIC 308 - Designation of Administrator, LIC 309 - Administrative Organization, LIC 610E Emergency Disaster Plan, and Liability Insurance Per California Code of Regulations, Title 22, Division 6, one deficiency was observed during this visit and can be found on LIC 809-D. A civil penalty was assessed due to a repeat violation within one year. An exit interview was held with Administrator and a copy of the reports and appeal rights were left at conclusion of visit..