Routine inspection·March 18, 2022

Licensing Program Analyst (LPA) Elsie Campos 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 met with the Administrator Mariam Kevliyan at 10:05 a.m. and explained the reason for the visit. The LPA toured the physical plant areas inside and outside, with Administrator Mariam Kevliyan at 10:30 a.m., to ensure there are no health and safety hazards. BEDROOMS: There are (4) four bedrooms designated for resident use and (1) one bedroom designated for staff use. Staff bedroom is part of the attached garage adjacent to the kitchen. Bedroom #3 and Bedroom #4 have a direct exit to the exterior. The facility has furnished each room with clean linens, appropriate furnishings, and sufficient lighting for resident use. Accessible disinfectants and air freshener were observed in Bedroom #4. Oxygen was observed in Bedroom #1, yet the LPA did not observe the appropriate ‘No Smoking – Oxygen in Use’ sign. RESTROOMS : Resident restrooms are clean, sanitary, and in operating condition with grab bars and non-skid surfaces. The LPA observed sufficient amounts of soap and paper products. The LPA observed signs in the bathroom attached to bedroom #1 and hallway bathroom promoting good hand hygiene. Restroom hot water measured at 114.3 degrees Fahrenheit at 10:55 a.m. FILES: During today’s visit, the LPA observed full bed rails on the bed of Resident #1 (R1). The Administrator provided bed rail orders for the resident. KITCHEN: Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Knives and over the counter medications were found in two unlocked drawers. The LPA observed a laundry room with a single turn latch for access located adjacent to the kitchen. Laundry detergents, cleaning supplies and/or toxins are also stored in the laundry area. The laundry room/garage was observed to be unlocked and accessible to residents. All other medications were stored in a locked cabinet. Hot water measured at 113.0 degrees Fahrenheit at 10:47 a.m. COMMON SPACES: The common spaces included the living room and dining area. At the time of the visit, living room and dining room furniture was observed to be in good condition. Flooring was checked for cleanliness, all areas were clean, sanitary and in good repair. The LPA observed cameras in all common spaces and a screened fireplace in the living room. Smoke detectors and carbon monoxide detectors are hardwired and interconnected. All were tested at 11:12 a.m. and observed to be operational. The fire extinguisher was observed to be full but did not have proof of service or receipt of purchase date. The LPA observed required postings on the wall at the entrance and throughout the facility. BACKYARD : The backyard has a covered outdoor area equipped with furniture for resident use. Two storage sheds were observed which included additional oxygen tanks and supplies. There were no bodies of water noted. INFECTION CONTROL: During today’s visit, the LPA spoke with the Administrator Mariam Kevliyan regarding the facility’s infection control practices. The Administrator was advised that they need to ensure that visitors upon entry are signing in at a central entry point for symptom screening, temperature checks, and sanitation. The facility has a sufficient amount of Personal Protective Equipment (PPE). The Administrator was advised that they may request additional PPE with Licensing if they need it. 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 reviewed facility’s policies and procedures as it pertains to infection control. 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.