Routine inspection·May 30, 2023

Licensing Program Analyst (LPA) Angel Ascencio conducted a required annual inspection to the above facility. The LPA met with Administrator Mary Ann Howe at 09:40 a.m. Entrance interview conducted. The LPA and Administrator Howe toured the physical plant areas inside and outside with the applicant to ensure there are no health and safety hazards. BEDROOMS: All resident rooms are set up with beds, night stands, lamps, chests of drawers, chairs and closet space. The beds are furnished with box springs, comfortable mattress and clean linen; which includes, a mattress pad, top and bottom linens, pillowcases, blanket (if needed) and a bedspread. Lighting in the rooms appeared adequate. The bedrooms were large enough to allow for easy passage between the beds. In addition, no bedroom was used as a passageway to another room, bath or toilet. There are five (5) total rooms - one (1) is a staff room, two (2) are shared, and 2 are private. RESTROOMS : There are three (3) bathrooms for resident use; the full bathroom in the hallway is designated for staff and guests. Resident bedroom #1 and #5 have an attached bathroom that is shared between bedroom #1 and bedroom #5. Resident bedroom #3 has an attached bathroom for private use. During the visit, the LPA observed signs in all of the bathrooms pertaining to proper hand hygiene. All cleaning supplies were inaccessible to client in care. In addition, restroom hot water measured under 120.0 degree F. KITCHEN: Kitchen knives are stored in a locked closet by the kitchen. The supply of dishes, utensils, pots, pans and drink ware is adequate. The freezer was maintained at zero degrees Fahrenheit (0*F) and the refrigerator was maintained at 40*F. Continued on LIC 809 - C COMMON SPACES: In the common areas, walls and flooring were checked for cleanliness and good condition. At the time of the visit, common seating area and dining room furniture was observed to be in good condition. Chairs were observed to be at least 6 (six) feet apart for social distancing. The LPA observed the required postings in the common hallway. Fire extinguishers were observed to be serviced within the last year. The facility smoke alarm system is hardwired and operated normally at the time of visit. Medications were observed to be locked in a closet by the kitchen and contained at least 30 days of worth of medication. The backyard has a covered outdoor area equipped with furniture for resident use. There were no bodies of water noted. INFECTION CONTROL: During today’s visit, the LPA spoke with the Administrator 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. The facility’s policies and procedures as it pertains to infection control are adequate. 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. At 1:30 p.m., during medication review, LPA did not observed Folic Acid 50 mg inputted in the centrally stored records. Exit interview conducted and a copy of the report and appeal rights were issued to Administrator.