Routine inspection·September 14, 2021

On 9/14/2021 at 1:20 PM, Licensing Program Analyst (LPA) Leslie Ibo conducted an infection control annual inspection and explained the purpose of the visit with Paul Lam. LPA observed 5 residents during the visit. Facility has a completed mitigation plan. LPA inspected the facility inside and outside. Infection control designated leader is the Administrator. There was at least 7 days of nonperishable and 2 days of perishable foods. Facility room temperature was maintained at least 72 degrees Fahrenheit. A certified administrator is on site a minimum of 20 hours a week to oversee proper business operation. Smoke and Carbon monoxide detectors were operational. Water temperature was checked 105.5 degrees Fahrenheit. Fire extinguisher has a check tag Sept. 2021. Continued on next page LIC 809-C LPA observed the following: · Facility DOES NOT document daily COVID-19 symptom checks, and any change in condition for staff and residents. Technical assistance provided. Proof of correction needs to send to LPA on or before 9/24/2021. · Facility has NOT conducted staff training on infection prevention, symptoms, transmission and PPE use. Type B violation was cited. Proof of correction need to be submitted on or before 9/24/2021. · Facility DO NOT have adequate 30-day supply of PPE (e.g., face masks, respirators, gowns, gloves, and eye protection such as face shield or goggles). Proof of correction needed by 9/24/2021. · Signs are not posted throughout facility to promote hand washing, cough/sneeze etiquette, and physical distancing. · Signs are NOT posted throughout facility to encourage residents to report acute respiratory illness to staff. · Trash bin with lid was recommended to Administrator for the bathrooms and common areas of the facility. Technical assistance was provided. Deficiencies are cited from Title 22 California Code of Regulations (see 809D). Failure to submit proof of corrections by plan of correction due dates, and any repeat violations within 12-month period may result in civil penalties. Deficiencies and plan and proof of corrections were discussed with Paul Lam. Exit interview conducted and a copy of this report provided. Appeal rights was given.