Routine inspection·August 22, 2022

On 8/22/22 at 8:50 AM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct an Annual inspection. LPA explained reason for inspection and was granted entry by staff. Licensees Susan Baal and Ulysis Baal arrived a short time later. LPA toured inside and outside of the facility. No obstructions observed and pool gate in backyard was observed locked and inaccessible. 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 sink. Beds in the shared bedrooms were observed to be at least 6 feet apart. LPA checked residents’ locked medications and observed a 30-day supply. Food supply was checked. Cleaning and PPE supplies were checked. Staff records were reviewed for good health. Facility staff observed to be wearing facial coverings. Resident’s files have updated emergency contact information. Administrator certification is current. The following deficiencies were observed: 1. S1 was working in the facility and was not associated to the facility. S1 had worked two days in the facility. 2. LPA found that the cabinet door, where centrally stored medication is kept, was unlocked and accessible. Deficiencies are being cited based on LPA observation, interviews conducted, and record review in accordance with the California Code of Regulations, Title 22, see LIC809D. A civil penalty is being assessed in the amount of $100 per day, for a total of $200. See LIC421BG for more details. An exit interview was conducted. A copy of this report and appeal rights were discussed and left with Licensee Susan Baal, whose signature on this form confirms receipt of these documents.