Routine inspection·May 11, 2022

On May 11, 2022, Licensing Program Analyst (LPA) DeAnna Williams-Lyons arrived unannounced to conduct an annual Inspection. LPA met with Helen Guzuvaty, Caregiver and informed her the reason for the visit. Prior to the visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; contacted licensee and completed a facility risk assessment. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N-95 Masks. Helen and LPA conducted the infectious control questionnaire with no issues. LPA observed the following: Administrators Certificate is valid expiring December 2023. Fire extinguishers fully charged. Smoke detector and Carbon Monoxide detector are functional. Facilities temperature measured 70 degrees F. Common areas were clean and in good repair. Facility has required (2) day perishable supply of food and (7) supply of non-perishable food. The facility is a 6 bed home. All rooms had the required furniture and lighting. All residents have had their vaccinations and boosters. Per California Code of Regulations, Title 22, no deficiencies were observed. The administrator shall submit updated copies of the LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610D the Emergency Disaster Plan, and copy of current Liability Insurance to update the facility file in our Regional office.. Administrator shall submit the listed documents to Licensing no later than June 11, 2022. Exit interview with was conducted and a copy of this report was left with Helen.