Routine inspection·July 22, 2022

On 7/22/2022, Licensing Program Analyst (LPA) Lourdes Montoya conducted an unannounced annual required visit with a primary focus on Infection Control measures using the new CARE Inspection Tool. Upon arrival, LPA called the facility to conduct a risk assessment. LPA spoke with Licensee Alice Galang, who confirmed the facility is Covid-19 free. LPA met with House Manager Angelito Costa shortly after and explained the purpose of today's visit. Upon arrival at the facility, LPA met with Facility House Manager, Angelito Costa, who granted access and allowed LPA to enter the facility to conduct an annual inspection. Administrator Alice Galang joined the visit shortly after. The facility is licensed for elderly residents ages 60 and older, cleared for six (6) bedridden residents. Hospice waiver granted for one (1) terminally ill resident. There is one bedridden resident on today’s visit. The administrator’s certificate expires on 8/29/22. During the visit, LPA toured the facility with HM Angelito Costa. This facility consists of four (4) resident bedrooms, one (1) staff bedroom, three (3) bathrooms, kitchen, living room/TV room, dining room, shaded patio and a garage. Operable smoke detectors in bedrooms and hallways were observed. One carbon monoxide detector located near the main entrance door is operable. One fire extinguisher last serviced on 9/30/2021 located near the main entrance door. The last facility fire drill was on 6/6/2022. LPA observed the facility is clean, sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, and toxins were stored and not accessible to resident. The kitchen was inspected and there is sufficient perishable and non-perishable food available. Report Continued in LIC 809-C There are no pools or bodies of water on the premises. There are no firearms on the premises and other dangerous weapons. Potentially dangerous items are kept inaccessible to residents with dementia. Centrally stored medications are locked in a cabinet located in the kitchen. The first aid kit has all the required supplies. Toxic chemicals are locked in a cabinet in the kitchen. The facility has a written emergency disaster plan posted on the bulletin in the dining room. The facility is maintained at a comfortable temperature. There are working lights or lamps in each room at the time of visit. There are grab bars for each toilet and shower used by residents. Showers have non-skid mats. During the visit, LPA observed the following to be in compliance: the facility's infection control practices; sanitizing stations in common areas and restrooms; every staff was wearing a face covering; the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. The facility has a Mitigation Plan Report approved by CCLD. According to California Code of Regulations (Title 22, Division 6, Chapter 8), LPA observed deficiencies and cited in LIC 9099D. A technical assistance was issued to licensee. An exit interview was conducted and a copy of the Facility Evaluation Report and Appeal Rights were provided to Licensee Alice Galang.