Routine inspection·October 26, 2022

On 10/26/2022 Licensing Program Analyst (LPA) Antonia Alvizar conducted an unannounced required annual visit with a primary focus on Infection Control measures using the new CARE Inspection Tools. Upon arrival at the facility, LPA Alvizar conducted a risk assessment at the front door. Based on the assessment, the facility is clear of Covid-19 infection. LPA verified that the facility has an approved mitigation plan report. On 10/26/2022, Licensing Program Analyst (LPA) Antonia Alvizar conducted an unannounced required annual visit with a primary focus on Infection Control measures using the new CARE Inspection Tool. Upon arrival at the facility, LPA Alvizar called Caregiver, Rosana Tan and conducted a risk assessment via-telephone and the purpose of the visit was explained. Based on the assessment, the facility is clear of Covid-19 infection. LPA verified that the facility has an approved mitigation plan report. The facility is licensed for six (6) non-ambulatory residents and an approved hospice waiver for four (4) resident. Currently, there are three (3) hospice residents present during today’s visit. LPA met with the Caregiver, Rosana Tan and both toured the inside and outside grounds of the facility. LPA was properly screened for Covid-19 symptoms and temperature was checked by Caregiver, Rosana Tan. Later Manager Nawal Sfeir arrive to the facility and join us. LPA was properly equipped with Fit tested N-95. During the tour, LPA observed the facility’s infection control practices. LPA observed a sanitizing station at the facility entrance; visitors log with Covid-19 screening and temperature log. PPE supplies are readily available to staff, and an additional 30-day supply of PPE is stored in a storage room; sufficient paper, cleaning, and disinfecting supplies were observed. The facility’s designated visitation area is the back patio or front living room. LPA observed staff maintaining 6 feet physical distancing, and each person wears a face covering. LPA observed required postings throughout the facility. Continue on 809c All six residents with memory care needs. All rooms were inspected. Each resident has their own individual room. Beds and bedding supplies were in good condition, adequate lighting provided, storage for residents. Manager, Nawal provided to LPA a copy of Liability Insurance (Certificate of Property Insurance) and Premium Breakdown documentation. LPA observed water in bathroom 4 was shown to be at 129.8 F which poses an immediate health, safety or personal rights risk to persons in care. During the visit LPA observed plumber corrected the water temperature. This requirement is not met as evidence by: Maintenance and Operation- Type A: 87303(e)(2) Water supplies and plumbing fixtures shall be maintained as follows: (2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degrees C) and not more than 120 degree F (49 degrees C). An exit interview was conducted, and a copy of this report and citation was provided to Manager, Nawal Sfeir.