Routine inspection·February 6, 2023

Licensing Program Analyst (LPA) David Espana and Licensing Program Analyst (LPA) Antonine Richard, and Licensing Program Analyst (LPM) Ulysses Coronel conducted an unannounced Annual required visit with a primary focus on infection control measures. LPAs and LPM was met by Ilana Yazdi, Controller, and the purpose of today’s visit was explained. The facility is licensed to serve 176 residents 64 non-ambulatory and 5 bedridden in room # 104, #106, #108, #118 and #128. There are currently 82 residents in placement total . Wooster Building : consists of 50 resident bedrooms w/ private bathrooms, dining room, kitchen, activity rooms. and an underground garage. Olympic Building: consists of 62 resident bedrooms w/ private bathrooms, dining room, kitchen, activity rooms. and an underground garage. LPA and staff toured the physical plant. There are no bodies of water or firearm/ammunition on the premises. All client rooms were checked. Beds and bedding were in good condition, adequate lighting provided, storage for client personal belongings was observed. Walls and floors were in good repair, except for bedrooms number 226 and 230 which had damage due to recent fire incident. Beds had a Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were clean and operational. During today visit 2/6/23 team observed room 109 water temperature at 123.5F and room 127 water temperature at 125.4F. In building Wooster, A comfortable temperature is maintained in the facility. LPA observed the facility to be clean and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning agents, toxins, and sharps were inaccessible to clients. The kitchen was inspected and there is not enough non-perishable food available which is stored properly. Fire extinguisher was charged, smoke detectors and Carbon Monoxide were operable. During the visit, LPA observed the facility infection control practices. LPA observed screening protocols for visitors, staff and residents, sanitizing stations ( Located in common areas and restrooms). LPA observed staff and residents were wearing face coverings, an isolation room and required postings throughout the facility. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). LPA advised the Administrator to continuously monitor the Centers for Disease Control (CDC) website and Community Care Likening Provider Informational Notices (PIN) for any updates relating to COVID-19 guidance. During today’s visit there were deficiencies observed, Title 22 Regulations are being cited, please LIC809D. Exit interview held, and plans of corrections developed. A copy of the report and appeals was provided to LIDA ZARAFSHAN, Administrator.