Routine inspection·November 24, 2021

Licensing Program Analyst (LPA) Darius Wiliams conducted an unannounced Annual Insepction visit. LPA Williams met with staff Luningning Lansangan, and discussed the purpose of the visit. LPA D. Williams contacted Licensee, Lilabeth Estomata, via phone and discussed the purpose of the visit. LPA Williams toured the facility with staff. LPA Williams observed a visitor/temperature check log, and disinfection station at the front entrance. Facility has one entry and exit point. Hand sanitizer was readily available to residents and visitors. Social distancing is maintained in the common areas. Hand washing and other various Covid-19 related signs were observed in the common areas. LPA Williams observed a two day supply of perishable food and seven day supply of non-perishable food. Cleaning supplies and medication were observed behind a locked door. LPA Williams observed the following personal protective equipment in storage; gown, goggles, gloves, and masks. LPA Williams observed staff training records regarding Covid-19 mitigation and infection control. LPA Williams observed all facility staff and visitors wearing masks. Licensee agreed to submit the following documents to Community Care Licensing by 12/3/2021: Personnel Report (LIC 500), Designation of facility responsibility (LIC 308) Covid-19 mitigation plan (LIC 808), LIC 601's for each resident, and Administrator certificate. No deficiencies were cited at this time, an exit interview was conducted, and a copy of this report was provided.