Routine inspection·October 11, 2021

Licensing Program Analyst (LPA) Salia Walker arrived at the facility unannounced to conduct a required Annual visit at 1:15 p.m. This annual had a specific emphasis on infection control practices and procedures. The LPA met with Designee Gohar Shahinyan at 1:22 p.m. and explained the reason for the visit. The LPA toured the physical plant areas inside and outside, with the Gohar Shahinyan at 1:27 p.m., to ensure there are no health and safety hazards. BEDROOMS: The LPA observed the resident bedrooms which were furnished with clean linens, appropriate furnishings, and sufficient lighting. RESTROOMS : Resident restrooms are clean, sanitary, and in operating condition with grab bars and non-skid surfaces. The LPA observed sufficient amounts of soap, paper products, and hand-washing signs in each restroom. Between 1:33 p.m. to 1:40 p.m., hot water temperatures measured between 113.5 and 117.8 degrees Fahrenheit in the common and private bathroom(s). At 1:28 p.m., the LPA observed there were accessible cleaning supplies and chemicals in common bathroom #1. The Designee secured it at the time of observation. KITCHEN: Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. All knives and cleaning supplies in kitchen were observed to be properly stored and locked at time of visit. Hot water measured 116.8 Fahrenheit at 2:32 p.m. At 1:45 p.m., the LPA observed five (5) out of six (6) resident medications in kitchen cabinet were prepared for more than 24 Hours. The LPA advised the Designee that per Title 22 Regulation each resident's medication shall be stored in its originally received container, and no medications shall be transferred between containers. From 2:40 p.m. until 3:45 p.m., the LPA conducted a Medication assessment with Designee Gohar Shahinyan. All medication was counted for, and placed back into its original container. Continue on LIC 809C.. COMMON SPACES: In the common areas, walls and flooring were checked for cleanliness and good condition. At the time of the visit, living room and dining room furniture was observed to be in good condition. The LPA observed required postings in the hallway near the living room. One fire extinguisher was observed to be fully charged and purchased on 05/2021. The cabinets next entrance door contains additional nonperishable and perishable food items. BACKYARD: The backyard has a covered outdoor area equipped with furniture for resident use. There were no bodies of water noted. The garage is detached to the facility. The garage is used as storage for addition supplies. INFECTION CONTROL: During today’s visit, the LPA spoke with the Designee regarding the facility’s infection control practices. Upon entry, the facility had a central entry point for symptom screening, temperature checks, and sanitation station. The LPA observed an adequate supply of Personal Protection Equipment (PPE) and the facility is able to obtain additional supplies as needed. The facility’s cleaning protocol is sufficient. If needed, the facility has the capacity to designate a single isolation room if the facility has a confirmed case of COVID-19. The facility does not have a confirmed case of COVID-19 at this time and the LPA reviewed facility’s policies and procedures as it pertains to infection control. The following deficiencies were observed (See LIC 809-D.) and cited from the California Code of Regulations, Title 22 and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted. A copy of the report and appeal rights were provided.