Routine inspection·November 24, 2021

Licensing Program Analyst (LPA) Vasallo conducted an annual required visit. LPA met with caregiver, Mark Santiago and explained the reason for the visit. The Administrator is currently out of town and unavailable. LPA used the infection control tool to evaluate the facility. LPA inspected the physical plant, COVID-19 procedures, reviewed residents' medications, observed food supply, and reviewed resident and staff files. Facility has submitted a mitigation plan and the plan has been approved. All resident bedrooms were toured. Each bedroom has a smoke detector, bed, linen, dresser, light, and sufficient closet space. Both bathrooms were toured. Bathrooms have the required grabs bars and non-skid mats. The hot water was 113.8 degrees which is within the required 105 - 120 degrees. The kitchen was toured. All appliances were operating properly. There was a sufficient amount of perishable and non-perishable food. The common areas including the living room and dining room are clean and have the required furniture. The backyard has a shaded area and sitting area. The facility does not have any cameras inside or outside the home. LPA reviewed all resident files. Resident #1 (R1) and Resident #2 (R2) were observed using half-length bed rails on their beds. R1's and R2's files were reviewed and did not contain physician's orders for bed rails as required. R1 is on hospice and physician's report indicates R1 is bedridden. Facility does not have an approved bedridden plan of operation on file. LPA reviewed staff files. Files were complete including but not limited to first aid certificates, health screenings, proof of training, and proof of fingerprint clearance. LPA reviewed all residents' medications. Medications are documented properly and given as prescribed. At the time that LPA entered the facility, staff did not assess or take LPA's temperature. Also a visitor was seen entering the facility and staff did not assess the visitor or require the visitor to sign-in as required per COVID-19 procedures. Per California Code of Regulations, Title 22, the deficiencies observed are documented on the attached 809D. Exit interview held. A copy of the report and appeal rights were provided to caregiver.