Post-licensing visit·October 8, 2021

Licensing Program Analyst (LPA) M. Yang arrived unannounced for a Post Licensing -Infection Control Inspection. LPA met caregiver Amalia (Amy) Mallari. LPA introduced self, stated the purpose of the visit, and requested to meet with the Administrator. Upon entry staffs was observed not wearing facial covering. Administrators, Pacita Baltazar and Alex Babakhani was called and arrived shortly. LPA conducted a complete tour of the facility with the Administrators. All three residents present during visit. LPA observed cough etiquette and social distancing posting. Facility was observed at a comfortable temperature, clean, and no passageway obstructions or fire hazards inside. Facility was free from ground obstructions and odor free. Common areas were observed to have adequate seating and lighting available. Kitchen was toured and observed. Knives were observed kept locked and secure in the kitchen pantry. LPA observed a 2-day supply of perishable and 7-day supply of non-perishable food. Medications observed locked in two cabinets in the kitchen. A fire extinguisher was observed and had a service date of 07/25/2021. Cleaning supplies and chemicals observed to be locked in a closet in the laundry room. LPA observed an extra supply of bed linens and personal hygiene products. Bedrooms were observed furnished and lit. LPA observed hand washing signs by bathroom sinks. Hot water temperature ranged between 109.6 to 112 degrees F. Outside of facility toured. Exits were open and free of obstructions. LPA observed side gate to be self-latching. All resident’s file reviewed to have updated emergency contact information. LPA observed a 30 day PPE supplies. Resident’s MARS reviewed. Staff’s file was also reviewed with current 1 st Aid/ CPR. No deficiencies issued during this inspection. Exit interview was conducted. Due to COVID-19 precautionary measures, a copy of this report will be provided via email and an electronic read receipt confirms receiving this email. Report signed on-site.