Routine inspection·September 23, 2022

On 09/23/2022 at 10:55 AM, Licensing Program Analysts (LPAs) P. Watson and L. Francisco arrived unannounced to conduct an annual Infection Control Inspection. LPAs met with Cargiver Joan Tungcui and explained the purpose of the visit. LPAs spoke with Administrator on the phone and was told Joan could sign the report. During the Infection Control Inspection, LPAs toured facility with Joan 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, Covid questionnaires, 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. Facility staff were observed to be wearing proper PPE. Facility has a mitigation plan and maintains record of routine screening for residents and staff. At 11:40 am, LPAs reviewed 4 residents records. At 11:40 am, LPAs reviewed 4 staff records and 4 of 4 have current first aid training and associated to the facility. Continue on 809 C The following deficiency was observed during inspection: -At approximately 11:10 am LPA's observed a camera in R1 and R2 shared room - At approximately 11:15 am LPA's observed keys inserted in the centrally stored medicine cabinets and unlocked medication -At approximately 11:18 am LPA's observed unlocked laundry supplies in the laundry room. -At approximately 11:20 am LPA's observed unlocked tools and a gas lighter in the garage -At approximately 11:25 am LPA's observed several portable oxygen tanks without stands in the garage. -At approximately 11:28 am LPA's observed keys inserted in cabinet where cleaning supplies and knives were being stored -At approximately 11:30 am LPA's observed eggs sitting out in the kitchen The following forms are to be updated and submitted to CCLD by 9/30/2022. - LIC500- Personnel Report - LIC308- Designation of Administrative Responsibility - LIC610E- Emergency Disaster Plan - An updated copy of Administrator certificate 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 and a copy of this report provided along with Appeal rights.