Routine inspection·October 7, 2022

Licensing Program Manager (LPM) Ulysses Coronel and Licensing Program Analyst's (LPA) Mario Leon conducted an unannounced Annual required visit with a primary focus on infection control measures. LPM and LPA was met by caregiver Genevieve Librando and spoke to administrator Serguei Kalistratov via telephone and the purpose of today’s visit was explained. The facility is licensed to serve 6 non-ambulatory residents ages 60 and above, hospice waiver for 2. There are currently six (6) residents in placement .. The facility is a single-story structure located in a residential neighborhood. It consists of the following: 6 bedrooms, 3 bathrooms, family room/dining room, kitchen, living room, shaded area, indoor and outdoor activity area, laundry room and a detached garage. LPM, LPA and staff toured the physical plant. There are no bodies of water or firearm/ammunition on the premises. All client rooms were checked. Beds and bedding were in good condition, adequate lighting provided, storage for client personal belongings was observed. Walls and floors were in good repair. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured between 102.5 and 127.5 F. A comfortable temperature is maintained in the facility. LPA observed the facility to be clean and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning agents, toxins, and sharps were inaccessible to clients. The kitchen was inspected and there is enough perishable and non-perishable food available which is stored properly. Fire extinguisher was charged, smoke detectors and Carbon Monoxide were operable. During the visit, LPA observed the facility infection control practices. LPA observed screening protocols for visitors, staff and residents, sanitizing stations ( Located in common areas and restrooms). LPA observed staff and residents were wearing face coverings, an isolation room and required postings throughout the facility. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). LIC 809-C LPA advised the Administrator to continuously monitor the Centers for Disease Control (CDC) website and Community Care Licensing Provider Informational Notices (PIN) for any updates relating to COVID-19 guidance. During today’s visit there were deficiencies observed. Title 22 Regulations were cited and Technical assistance notes were provided please see LIC809D and LIC9102. Exit interview held. A copy of the report was provided to Genevieve Librando, staff.