Routine inspection·October 19, 2022

On 10/19/2022 at 12:15PM, Licensing Program Analyst (LPA) C. Fowler arrived unannounced to conduct Infection Control Inspection. LPA met with Caregiver, Edna Banagale and explained the purpose of the visit. Administrator Marylyn Judan arrived at approximately 12:40pm During the Infection Control Inspection, LPA toured facility 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. Visitors policy is posted on the front entrance. 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. Facility staff were observed to be wearing proper PPE. JPFacility has a mitigation plan and maintains record of routine screening for residents and staff. The following deficiencies observed during the visit: -At 12:20 pm, LPA observed gardening trimmers, 3 ladders, 3 rakes, wood planks, toilet pots, wheelchairs, wood, shovel, kingsford charcoal located in the backyard. 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. Appeal Rights and a copy of this report provided. Continue on LIC 809C Continue from LIC 809 Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 10/27/2022: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Current Administrator’s Certificate