Routine inspection·May 17, 2022

Licensing Program Analysts (LPAs) Galarza, Valeria Maldonado, & Ashley Calderon conducted an unannounced Required- 1 year visit focusing on COVID-19 Infection Control Practices. LPAs met with Administrator Barbara Tyler and explained the purpose of the visit. The facility does not have Dementia residents. A hospice waiver for 8 residents is in place. Facility is a 2-story building consisting of 73 resident rooms, 2 activity rooms, beauty salon, dining room, laundry room, and a courtyard patio area. The facility's last fire inspection was conducted on 5/3/2022 by Johnson Controls. Administrator certificate expires 7/13/2022. The following was inspected and observed during the inspection: COVID-19 Infection Control Practices were observed in common areas, isolation rooms/wing areas, and resident rooms. COVID-19 infection control signs were observed in all common rooms, and hallways. Infection control signs, and other signs are posted throughout the facility to promote hand washing, cough/sneeze etiquette, and social distancing. Individual rooms, empty rooms, or SIU in Corona are designated isolation rooms. Twenty one (21) resident rooms were inspected. Room # 211 & # 201 had plumbing issues. Room # 231 had broken vertical blinds. Seven (7) centrally stored resident medication records were reviewed. Medication errors were observed. R1 was missing medication Acetaminophen 325 mg, Resident (R2) has prescribed medications on Physician's Report, but they were not listed on the Medication Administration Report. No proof that R2 refuses medication physician orders was documented. R2 had Acetaminophen 500 mg in the room, but it was not listed on the MAR. Staff responsible for direct care and supervision were observed wearing masks. Sufficient supply of perishable for 2 days & non-perishable foods for 7 days were observed. Deficiencies were cited. See LIC809D. Exit interview was conducted with Administrator. A copy of the report and appeal rights were issued.