Routine inspection·December 20, 2021

Licensing Program Analyst (LPA) Darius Wiliams conducted an unannounced Annual Insepction visit. LPA Williams met with Staff, Sonia Dimas, and discussed the purpose of the visit. LPA Williams spoke with Administrator, Eric Lopez, via phone and discussed the purpose of the visit. LPA Williams toured the facility with staff. LPA Williams observed a mask and sanitizer at the front entrance. LPA Williams advised staff and Administrator to place a visitor and temperature check log at the front entrance. Facility has one entry and exit point. 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. Facility has the following Personal Protective Equipment available in storage; masks, gloves, gowns, and face shields. Staff have received training in Covid-19 mitigation and infection control. 2 of 3 residents files had up to date emergency contact information. LPA Williams advised Administrator to ensure staff have access to emergency contact information for all residents. Licensee shall submit the following documents to Community Care Licensing by 12/28/2021: Personnel Report (LIC 500), Designation of Facility Responsibility (LIC 308), transcribed Covid Mitigation Plan (LIC 808), and Administrator Certificate. No deficiencies were cited at this time, an exit interview was conducted, and a copy of this report will be provided via e-mail.