Routine inspection·July 14, 2021

On 7/14/2021 at 2:10 PM, Licensing Program Analyst (LPA) Leslie Ibo conducted an infection control annual inspection and explained the purpose of the visit with Administrator Lorica Hipolito. LPA observed 2 residents relaxing in the living room while the other 3 residents were resting in their bedrooms. Facility has a completed mitigation plan. LPA inspected the facility inside and outside. LPA observed COVID-19 posters posted in common areas to promote hand washing, cough/sneeze etiquette and physical distancing. Pathways were observed to be free of obstruction and fire hazards. LPA observed furniture spaced six feet apart for social distancing among residents in the living room. Infection control designated leader is the Administrator. There was at least 7 days of nonperishable and 2 days of perishable foods. Emergency food supplies were observed stored in the garage. Facility room temperature was maintained at 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. Continued on next page LIC 809-C.... LPA observed the following: · NO routine symptom screening (+/- temperature and symptom check) has been initiated at entry for all staff, residents, and visitors. · Facility DOES NOT document daily temperature and COVID-19 symptom checks, and any change in condition for staff and residents in order to track spread and why facility took certain steps to prevent and mitigate spread in the facility. · NO sign-in policy has been enacted with all visitors to ensure compliance with central entry point for symptom screening and to record contact information (for reporting requirements to public health officer and contact tracing). · Staff was observed NOT wearing a face covering, while in the facility. · Facility did not conduct staff training on infection prevention, symptoms, transmission and PPE use by an individual trained in infection control. (Deficiency) · Facility do not have adequate 30-day supply of PPE (e.g., facemasks, respirators, gowns, gloves, and eye protection such as face shield or goggles) . 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 Lorica Hipolito. Exit interview conducted and a copy of this report provided.