Routine inspection·February 7, 2022

Licensing Program Analysts (LPA's) Elsie Campos and Ashley Smith arrived at the facility unannounced to conduct a required Annual visit. This annual had a specific emphasis on infection control practices and procedures. The LPA's met with Administrator Zenaida Velasco and explained the reason for the visit. The administrator advised that there are currently no residents in the facility. The LPA's toured the physical plant areas inside and outside, with Zenaida Velasco at 9:56 a.m., to ensure there are no health and safety hazards. BEDROOMS: There are (4) four bedrooms designated for resident use. Bedroom #2 and Bedroom #4 have a direct exit to the exterior. The facility is capable of furnishing each room with clean linens, appropriate furnishings, and sufficient lighting for resident use. Bedroom #3 leads to a hallway, which allows for access to Bedroom #5 and Bedroom #6; however, those two rooms designated for staff. There is an exterior door that leads to Bedroom #5 and Bedroom #6. Staff are aware that once they have residents in Bedroom #3, staff would need to enter their rooms through the exterior door. RESTROOMS: There are (2) bathrooms designated for resident use. There is a bathroom designated for staff use only. Bathrooms are clean, sanitary, and in operating condition with grab bars and non-skid surfaces. The LPA's advised the Administrators to ensure that bathrooms were stocked with paper towels and hand-washing signs prior to allowing resident admissions. Between 10:41 a.m. – 10:44 a.m., the LPA's measured the hot water temperature in (2) two out (3) three bathrooms. The hot water temperatures measured between 123.3 and 124.3 degrees Fahrenheit. Continued on LIC 809-C. KITCHEN: Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. All knives and cleaning supplies were observed to be properly stored and locked at time of visit. Hot water measured at 124.1 degrees Fahrenheit at 10:39 a.m. COMMON SPACES: The common spaces included the living room, dining area, activity room, entertainment room and office area. The LPA's observed cameras in all common spaces and exterior. All areas were clean, sanitary and in good repair. Smoke detectors are hardwired and interconnected, there is a Carbon Monoxide detector installed at the facility. All were tested at 10:47 a.m. and observed to be operational. The fire extinguisher was observed to be full and last bought on 02/28/19. The LPA's observed required postings in the hallway in the living room. BACKYARD: The backyard has a covered outdoor area equipped with furniture for resident use. Two storage sheds were observed locked which included PPE supplies and additional cleaning supplies. The LPA's observed a Laundry room which is located in an enclosed patio adjacent to the kitchen. Laundry detergents, cleaning supplies, pesticides, and/or toxins are also stored in the laundry area cabinet. The laundry room was observed to be locked and inaccessible to residents. There were no bodies of water noted. INFECTION CONTROL: During today’s visit, the LPA's spoke with the Administrator Zenaida Velasco regarding the facility’s infection control practices. The Administrator was advised that they need to have upon entry, a central entry point for symptom screening, temperature checks, and sanitation station. The LPA's also advised the Administrator to maintain a 30-day supply of Personal Protection Equipment (PPE). The Administrator requested additional N-95 masks. 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 and the LPA's reviewed facility’s policies and procedures as it pertains to infection control. Lastly, the LPA's stated that they will send additional information via email in regard to signage to be posted around the facility. The following deficiencies were observed (See LIC 809-D.) and cited from the California Code of Regulations, Title 22 and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted. A copy of the report and appeal rights were provided via Email.