Routine inspection·May 17, 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 Staff Lea Ebueng and explained the reason for the visit. The LPA spoke to the Administrator over the phone Milagros Lopez and also explained the reason for the visit. The LPA toured the physical plant areas inside and outside, with staff to ensure there are no health and safety hazards. BEDROOMS: There are (3) three bedrooms designated for resident use. The facility has furnished each room with clean linens, appropriate furnishings, and sufficient lighting for resident use. RESTROOMS : The LPA observed resident restrooms to be clean, sanitary, and in operating condition with grab bars and non-skid surfaces. The LPA observed sufficient amounts of soap and paper products. Restroom hot water measured between 131.3 and 132.0 degrees Fahrenheit between 2:00 p.m. and 2:06 p.m. The LPA advised staff to immediately adjust the water heater temperature to ensure compliance. KITCHEN: The LPA observed the Kitchen oven, microwave, and dishwasher to be inoperable, and per the staff is not used. The facility has a 2 nd working microwave. The administrator was advised that all kitchen appliances need to be in good repair and operable. The facility has a sufficient supply of perishable food and nonperishable food. Knives, medications, and chemicals were locked and inaccessible. The facilities laundry closet is located in the kitchen which was locked and inaccessible to residents at the time of the visit. Continued on LIC 809-C COMMON AREAS: The common spaces included the living room and dining area. All areas were clean, sanitary and in good repair. The LPA observed required postings on the living room wall. One fire extinguisher was observed to be fully charged and last purchased on 3/29/22. Smoke detectors and Carbon Monoxide detectors are hardwired and interconnected, they were tested at 2:31 p.m. and confirmed to be operable at the time of the visit. BACKYARD: The backyard does not have a covered outdoor area equipped with furniture for resident use. The LPA observed an old patio set in disrepair with a flat piece of sheet wood being used as tabletop. A shopping cart was observed propped against the driveway wall. The LPA also observed old walking assistance devices, an old metal bedframe and miscellaneous items in disrepair that could be thrown away. A resident was using an old wheelchair to sit under a shaded ledge in front of the garage which is not appropriate. There were no bodies of water noted. The garage is attached to the house but has been converted to a separate living space but is being used for PPE storage and has an additional refrigerator. The administrator was advised to clean the backyard so that it may be accessible for resident use and free of any debris or obstructions. INFECTION CONTROL: During today’s visit, the LPA spoke with staff Lea Ebueng regarding the facility’s infection control practices. 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.