Routine inspection·June 21, 2022

On 06/21/22 at 9:40 a.m Licensing Program Analyst (LPA) Joscelyn Martinez arrived at the facility to conduct an unannounced annual inspection. Upon arrival LPA met with staff and then met with Administrator Designee Annabelle Pascua. The purpose of the visit was explained. Entrance interview conducted. A physical plant tour was conducted at 9:50 a.m and the following was observed: Infection Control: Covid-19 infection control signage were observed outside of the facility. Proper signage was also observed inside in the common areas. Staff screened LPA for covid symptoms and took LPA’s temperature. Facility has sufficient PPE supplies for more than 30 days. Food Inspection/Kitchen: LPA observed there to be sufficient stock of one-week non-perishable foods and two-day perishable foods. Food storage and preparation areas are clean and inaccessible to pests. Garbage cans have tight fitting covers in the kitchen. Sharps are centrally stored in a locked area. Medication are centrally stored in a locked cabinet in the kitchen area. Smoke detectors/carbon monoxide are located throughout the facility and are dual hardwired. Smoke detectors and carbon monoxide detectors were tested at approximately 10:05 a.m. and appear to be functional. Fire extinguisher has a purchase date of 04/11/2022. Common Areas: All common areas were observed to be clean and properly furnished. Facility’s temperature at the time of the visit was 81F. Resident Rooms: Facility has seven (7) bedrooms which of six (6) are designated for resident use. Facility has two live-in staff. All seven (7) bedrooms were toured and appear to be clean and properly furnished. LPA observed additional bedding and linens sufficient for all of the residents. All rooms have adequate lighting and furniture. Bathrooms: There are three (3) bathrooms in the facility of which two (2) are designated for resident’s use. LPA observed all bathrooms to be cleaned. At 9:54 a.m LPA toured the bathroom next to bedroom number three (3). LPA observed a can of cleaning supply under the bathroom sink. LPA asked staff to immediately remove the cleaning supply and store it in the locked cabinet located under the kitchen sink. The hot water was tested and measured 106.5 F, which is in regulation. All trash cans located in the bathrooms had tight fitting lids. (Continue on 809-C) Outside: LPA toured the outside area and observed appropriate outdoor furniture with a shaded covered area for residents. There is a shack located outside that is used for additional storage and laundry chemicals storage. The laundry area is located outside. There is a body of water that has a wooden cover and a gate around the pool making it inaccessible to residents. The following deficiency were observed and cited per Title 22 see attached LIC809D. Exit interview conducted. Report signed and delivered. Appeal rights delivered.