Routine inspection·July 27, 2023

Licensing Program Analyst (LPA) Angel Ascencio conducted unannounced required annual inspection to the above facility. LPA Ascencio met with staff at 09:45 a.m. Entrance interview conducted. Administrator Gigi Papazian and Alin Papazian arrived shortly after. The LPA toured the physical plant areas inside and outside at approximately 10:00 a.m. to ensure that there are no health and safety hazards. KITCHEN: At 10:00 a.m., the LPA toured the Kitchen. The supply of dishes, utensils, pots, pans and drink ware is adequate. The freezer was maintained at zero degrees Fahrenheit (0*F) and the refrigerator was maintained at 40*F. The supply of perishable and nonperishable food is adequate. LAUNDRY: At 10:05 a.m., the LPA observed the laundry area which is located in next to the kitchen. Appliances were clean, sanitary and in operable condition. BEDROOMS: There are four (4) bedrooms designated for resident use. All rooms are approved as bedridden rooms. Bedroom #1 and #2 are single occupancy. Bedroom #3 and #4 are double occupancy with exits to the exterior. Bedroom #3 and #4 also have bathroom within the rooms. The facility has furnished each room with clean linens, appropriate furnishings, and sufficient lighting for resident use. Storage space cabinet in hallway was observed containing clean linens for resident use. BACKYARD: The backyard has a covered outdoor area equipped with furniture for resident use. There were no bodies of water noted. Continued on LIC 809-C. COMMON SPACES: The common spaces included the living room and dining area. The LPA observed cameras in the common areas. A TV for resident use including games in a storage cabinet. All common areas, walls and flooring were checked for cleanliness and good condition. At the time of the visit, common seating area and dining room furniture was observed to be in good condition. Chairs were observed to be at least 6 (six) feet apart for social distancing. The LPA observed the required postings in the common hallway. Fire extinguishers were observed to be serviced within the last year. The facility smoke alarm system and carbon monoxide detector was tested and operated normally at the time of visit. Medications were observed to be locked in a cabinet next to the kitchen and contained at least 30 days of worth of medication. INFECTION CONTROL: There is 1 entry into the facility. Upon entry, the facility has a central entry point for symptom screening. The LPA noted that the facility is allowing visitors for both indoor and outdoor visitation. The LPA observed an adequate supply of Personal Protective 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 does not have a confirmed case of COVID-19 at this time. The facility’s policies and procedures as it pertains to infection control are adequate. The following was observed during today's visit: At 10:03 a.m., during kitchen tour, LPA observed an knife on top of the counter, an unlocked drawer full of knifes, and a pair of scissors in the sink. At 10:09 a.m., during common restroom tour, LPA observed 3% hydrogen peroxide, lighter, mouthwash, shampoo, conditioner and body wash accessible to resident in care. At 10:10 a.m., during resident room and private restroom tour, LPA observed case of nail polish, Vaseline, body wash, A&D Ointment, Skintimate shaving cream, neosporin, calmoseptine, Diclofenac Sodium %1 (Prescribed medication), Anti-Fungal Powder, Polysporin, and Triad Hydrophilic Wound Dressing. Continued on LIC 809 - C At 10:18 a.m., during garage tour, LPA observed an unlocked garage that contained, sulfur zinc oxide salicylic acid, Gain laundry detergent (x4), Box of Clorox, Box of Shampoo (18), Fabuloso, Diclofenac Sodium topical gel, a tool box with a hammer and screwdriver, and Raid Max Fogger. At 11:10 a.m., LPA observed RING cameras in all resident rooms. At 11:20 a.m., during staff file review, LPA did not observe active Administrator Certificate for Gohar Gigi Papazian. LPA checked the CCLD website in Active and Pending List. LPA did not observed a certificate active or pending. At 12:00 p.m., during file review, 1 out of 4 residents did not have bed rail orders. Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D). Exit interview conducted and a copy of the report and appeal rights were issued.