Routine inspection·September 7, 2022

Licensing Program Analysts (LPAs) Yating Yang and Joe Katrdzhyan conducted an unannounced site visit for the Required - 1 Year inspection. Upon arriving at the facility LPAs met with the Licensee representative Ann Hamilton and were later joined by the Administrator Assistant Monique Jordan who assisted with the visit. The facility is licensed to serve elderly residents age 60 and above. Fire clearance was approved for seventy-two (72) non-ambulatory residents. Hospice was approved for ten (10) residents . Currently NO residents are on Hospice . During today's visit, LPAs used the infection control domain to complete the Required - 1 Year inspection. Also, the physical plant was toured, medication and food supplies were reviewed . The interior and exterior physical plant was inspected. There is only one entrance being utilized at the facility. COVID -19 related materials were posted on the main door. Screening area is located immediately upon entrance. Sign in sheet, hand sanitizer, gloves and masks are available. A tour of the two story facility includes: All business offices and the kitchen, located on the first floor and resident rooms, bathrooms, common restrooms, shower rooms, medication room, laundry room, linen cabinets, activity/television room, beauty shop, library and a dining room, located on the second floor . During today's visit, LPAs toured the physical plant areas inside and out to ensure there are no health and safety hazards and Physical Plant is in compliance with Title 22 Regulations. The facility has central air and heating accommodations. LPAs toured the second floor and randomly selected #9 resident rooms. All selected bedrooms were furnished with required furniture with operational call lights . Some bedrooms have private bathrooms and some have shared bathrooms . The auditory chimes at the exit doors were tested during the visit . Continue on LIC 809C The bathrooms were observed to be clean, operational and equipped with grab bars and paper supplies. The hot water temperature was tested throughout the facility and measured within compliance of Title 22 Regulations. The kitchen was inspected. LPAs observed kitchen equipment to be clean and in working condition. LPAs observed the food supply stored at the facility. There was a sufficient quantity of the various perishable and non-perishable food supplies. No pesticides or poisons were stored in the food areas. The fire extinguishers were observed to be fully charged and in compliance LPAs observed multiple pull-switch fire alarms throughout the facility . Smoke/carbon monoxide detectors were observed to be operational. The front yard of the facility is well landscaped and has a leveled walkway to the entrance. The outdoor area was enclosed and no bodies of water were observed. All residents medications were centrally stored and four of them were reviewed and the medications were administered as prescribed. The following deficiencies were observed during this visit: 1. Two bottles of the laundry detergent were found in the laundry room left accessible to residents, which poses immediate health and safety risks to the residents in care. 2. One private bathroom in room #20 has no running hot water. The staff will move the resident to another room temporarily until the plumber fixes the issues The plumber is scheduled to come out on 9-8-22 The following deficiencies were observed to be in violation of California code of Regulations, Title 22, Division 6 (refer to 809D) An exit interview was conducted and a copy of this report was provided to the Director along with the Appeals Rights.