Routine inspection·October 14, 2021

On 10/14/2021, Licensing Program Analyst (LPA) A. Walton conducted an Annual Inspection LPA met with Administrator, Joan Black and stated the purpose of the visit. A tour of the facility was conducted. COVID-19 guidelines are in place. Visitor log-in/temperature check was observed upon entry. Facility has one entrance/exit point. LPA conducted a tour of the facility with Administrator. Facility appeared cleaned with no obstruction or fire clearance issues. Hand sanitizer was readily available to residents and visitors. Social distancing is maintained in the common and dining areas. Bathrooms have trash cans with lid. Hand washing posters were observed by the bathroom sinks. LPA toured a sample of the facility units. Beds were observed to be at least six feet apart. LPAs checked residents’ locked medications and observed a 30-day supply. Upon entering the facility, LPA observed a square container of knives on the counter in the kitchen accessible to residents in care. Per Administrator, the door to the kitchen is usually locked and knives are stored inaccessible. Administrator removed the square container of knives and closed the kitchen door. Food supply was checked and there appeared to be an adequate supply. Cleaning and PPE supplies were checked. Facility staff was observed with mask on. Residents wear masks when away from the community. Resident’s files have updated emergency contact information. Based on observation, a deficiency is being cited in accordance with California Code of Regulations, Title 22, see attached LIC809D Exit interview was conducted and plan of correction was reviewed and developed with Administrator. Administrator was informed that as a COVID-19 precautionary measure, this report will be emailed. Report was signed.