Routine inspection·August 3, 2022

On 08/3/22 at 3:00 PM, Licensing Program Analyst (LPA) J. Sampair conducted an infection control annual inspection. Upon entry into facility, LPA explained the purpose of the visit. LPA met with and toured the facility with Licensee ERLINDA TUAZON. Facility has a Covid-19 Mitigation Plan and an Infection Control Plan. However, they are not following many aspects of the Covid-19 Mitigation Plan, including a lack of indoor signage regarding Covid-19 mitigation. The designated infection control leader is the Licensee. They have one central entry point that has been designated for universal entry screening with the station located near the front entrance with visitor's log and a no touch thermometer, hand sanitizer, and face masks. Facility follows daily cleaning, sanitation of frequently touched common surfaces with disinfectants. Carbon monoxide and smoke detectors were fully functional and the fire extinguisher had been serviced within one (1) year and it was fully charged. However, no Emergency/Disaster plan was posted. Centrally stored medications were in locked cabinets, and sharp objects were stored in locked closets and cabinets. The temperature inside of the facility was 78 and the hot water was 110 degrees Fahrenheit, both of which were in the safe range. An administrator is on site more than the required 20 hour minimum each week to oversee business operations. Facility cited with 3 Type B deficiencies: Continues on LIC 809-C . . . . . . Continued from LIC 809 Infection Control Practices - Type B: 87468.1(a)(2) - Few signs were posted in the facility to promote handwashing, cough/sneeze etiquette, and physical distancing. Additionally, the facility does not have a 30-day supply of PPE (e.g., facemasks, respirators, gowns, gloves, and eye protection such as face shield or goggles) nor a list including items on hand or indicating where such items will be acquired (such as CCL Regional Office) and when. Incidental Medical and Dental - Type B: 87465(c)(3) - MAR records incomplete. Disaster Preparedness - Type B: 1569.695(a) - Emergency and Disaster Plan 610E was incomplete and an incomplete resident roster. Updated copies of the following documents were requested for facility file and are to be submitted to CCL on or before 08/10/22: · LIC500 - Personnel Report · LIC308 - Designation of Facility Responsibility · LIC610E - Emergency/Disaster Plan · Evidence of Liability Insurance & Surety Bond A total of 3 deficiencies cited during this visit. Exit interview conducted and a copy of this report provided.