Routine inspection·February 2, 2022

On 02/02/2022, Licensing Program Analyst (LPA) Sandra Urena, arrived at the facility unannounced to conduct a required annual inspection. LPA Urena arrived at the facility at 1:30 p.m., and was greeted by the staff. The administrator was not present at facility and the staff call the administrator to announce the LPA’s visit. The administrator stated that they would arrive at the facility in 30 minutes. This annual inspection had a specific emphasis on infection control practices and procedures. The purpose of the inspection was discussed with the administrator Gohar Khachatryan. Infection Control: Upon entry, the facility has a sign in book and sanitizing gel. Infection Control signage was visible at entrance. Temperature was checked and recorded. At 2:00 p.m., LPA Urena and administrator conducted a tour of the inside and outside the facility to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. Common Areas: At 2:00 p.m., the common seating area, and dining room furniture were observed to be in good condition. Fire extinguisher was observed to be serviced within the last year. Walls, and floors were in clean condition Kitchen: At 2:05 p.m., LPA Urena and administrator observed the kitchen/dining area. Knives are stored in a locked cabinet drawer. Kitchen appliances were in operable condition. The facility has enough supply of perishable and non-perishable food. Freezer and refrigerator are stocked with a variety of foods. Emergency food supply is adequate for six residents and two staff. Continues on LIC 809C... Bedrooms: At 2:10 p.m., LPA Urena observed the residents’ bedrooms. Bedrooms were furnished appropriately with appropriate furnishings and sufficient lighting. Linens are clean and in good condition. Bathrooms: At 2:15 p.m., LPA Urena observed the residents’ restrooms. Restrooms were clean, shower area was in clean condition with grab bars and a non-skid mat available. Paper towels were available for drying hands. Handwashing signs were displayed, and sufficient amounts of soap and paper products in each restroom. Outdoor Space: At 2:20 pm., LPA Urena observed the Outdoor space. Backyard has a covered outdoor area equipped with furniture in good repair for residents’ use. There were no bodies of water noted. Side gate is unlocked. Facility Records: At 3:00 p.m., LPA Urena reviewed records. Files are in good order, and meet requirements. LPA Urena 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’s policies and procedures as it pertains to infection control are adequate No citations were issued. Exit interview was conducted, the report was reviewed with the administrator and a copy of the report was provided. Signatures were obtained.