Routine inspection·September 16, 2021

At 10:00 a.m., Licensing Program Analyst (LPA) Emily Peraldi arrived at the facility unannounced to conduct a required annual visit. LPA was greeted and screened by staff, ROBERTO GAMILLA. At 10:20 a.m. Licensee CARRIE ACOSTA arrived at the facility. This annual had a specific emphasis on infection control practices and procedures. Between 10:05 a.m.- 11 a.m., LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. KITCHEN: At 10:11 a.m., LPA observed the kitchen/dining area. Knives are stored in a locked cabinet. Kitchen appliances are in operable condition. The facility has a sufficient supply of perishable and non-perishable food. At 10:11 a.m., LPA observed a baby gate at the entrance into the kitchen. Staff removed the baby gate by the end of the visit. At 10:43 a.m., hot water measured at 112.1-degree Fahrenheit. LPA observed the fire extinguisher to be fully charged and last serviced on 10/30/2020. BEDROOMS: LPA observed resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Inside temperature was maintained at a comfortable level. RESTROOMS: Restroom is relatively clean and sanitary and in operating condition with grab bars and non-skid mats. At 10:45 a.m., hot water measured at 116.0-degree Fahrenheit. OUTDOOR SPACE: At 10:14 a.m., LPA observed the back patio, which has a covered outdoor area for resident use. There is a gate on the side of the facility designated for an emergency exit. Continued on LIC 809-C. Continued from LIC 809. Common Areas: At 10:12 a.m. LPA observed a daybed located in the living room area. Interviews with residents and Licensee revealed that the daybed is used as a couch for the most part but sometimes staff do take naps on the daybed. LPA spoke with Licensee in regard to the daybed and suggested getting a couch instead. LPA reminded Licensee that staff cannot sleep in the daybed that’s located in the living room area. There is a staff room that remains locked. At 10:15 a.m. LPA observed disinfectant wipes and alcohol in the common area. The staff removed these items upon observation. Medications and resident records are located in a locked file cabinet near the living room area. INFECTION CONTROL: During today’s visit, the LPA spoke with the Licensee regarding the facility’s infection control practices. Upon entry, the facility has a central entry point for symptom screening, temperature checks, and a sanitation station. LPA observed a 30-day 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 has not had a confirmed case of COVID-19 at this time; however, the facility’s policies and procedures as it pertains to infection control are adequate. At 10:20 a.m., LPA conducted Infection Control mitigation module with Licensee. The following deficiency was 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. Report issued and a copy of the report and appeal rights was provided via email.