Routine inspection·September 23, 2022

On 09/23/2022 at 2:30 PM, Licensing Program Analysts (LPAs) P. Watson and L. Francisco arrived unannounced to conduct an annual Infection Control Inspection. LPAs met with Administrator, Marjorie and explained the purpose of the visit. During the Infection Control Inspection, LPAs toured facility with Marjorie 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 with touchless lids. Facility staff were observed to be wearing proper PPE. Facility has a 30-day supply of PPEs maintained at central location and easily accessible for staff. Facility has a mitigation plan and maintains record of routine screening for residents and staff. LPAs observed facility passages inside and out free of obstruction. At 3:00 pm, LPAs reviewed 3 staff records and 3 of 3 have current first aid training and associated to the facility. Continue on 809 C. The following deficiency was observed during inspection: -At approximately 2:40 pm LPAs observed a resident living in a designed room for caregivers The following forms are to be updated and submitted to CCLD 9/30/2022: - LIC500- Personnel Report - LIC308- Designation of Administrative Responsibility - LIC610E- Emergency Disaster Plan - An updated copy of Administrator certificate The following deficiency was observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct deficiency by POC date may result in additional Civil Penalties An immediate $500 Civil Penalty is being assessed. Exit interview conducted and a copy of this report provided along with Appeal rights.