Routine inspection·April 6, 2022

On 4/6/2022 at 12:50PM , Licensing Program Analyst (LPA) Leslie Ibo conducted an infection control annual inspection and explained the purpose of the visit with Shirley Virden, staff. Administrator Nicolette Lake arrived at the facility after 20 mins. Facility has a completed mitigation plan. LPA inspected the facility inside and outside. LPA observed COVID-19 signage 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. 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 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 The following was observed and deficiency was cited: · V1 is not fingerprint cleared, staff an Administrator stated that V1 has been coming to the facility couple of times a week and interact with residents in care. · S4 was not associated at the facility. · Soap pods was unlocked and accessible to residents in care · Medications was observed prepared at least 5 days in advance and was not in the original container. 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. A $500.00 civil penalty was assessed during today's visit. Deficiencies and plan and proof of corrections were discussed with Nicolette Lake. Exit interview conducted and a copy and appeal rights of this report provided.