Routine inspection·April 19, 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 and explained the reason for the visit. The Administrator Serguei Kalistratov arrived shortly thereafter. The LPA, with the guidance of staff, toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. BEDROOMS: The LPA observed the resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. There are six bedrooms for resident use. RESTROOMS: Resident restrooms are clean and sanitary and in operating condition with grab bars and non-skid surfaces. During the visit, the LPA did not observe signage 2 out of 3 bathrooms pertaining to proper hand hygiene. In addition, restroom hot water measured between 115.8 and 138.2 degrees Fahrenheit between 10:32 a.m. and 10:42 a.m. COMMON SPACES: In the common areas, walls and flooring were checked for cleanliness and good condition. At the time of the visit, living room and dining room furniture was observed to be in good condition. All exits have functioning auditory devices. Smoke detectors are hardwired and interconnected and tested at 11:15 a.m. The fire extinguisher was observed to be full and last bought on 5/26/21. The LPA observed cameras in all common spaces and a screened fireplace in the living room. The LPA did not observe all the required postings in the common area. Amongst the missing postings were the department provider information notices (PIN) and department let me know poster. The administrator was reminded of the department’s guidelines regarding postings and signage. In addition, at 10:36 a.m., the LPA observed accessible personal hygiene, over the counter medications and prescription medications in the hallway closet, belonging to staff. These items were properly secured at the time of the visit. BACKYARD: The backyard has a covered outdoor area equipped with furniture for resident use. At 10:57 a.m., the LPA observed the door to the water heater to be in disrepair, and advised the administrator to ensure it is repaired and secured. KITCHEN: The LPA observed the Kitchen dishwasher to be inoperable, and per the administrator is not used. 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; however, the LPA observed expired hot dog buns, expired milk, and moldy cauliflower in the kitchen between 10:46 a.m. and 10:49 a.m. These items were disposed of at the time of observation. At 10:45 a.m., the LPA observed accessible cleaning supplies under the kitchen sink. At 10:33 a.m. the LPA observed unlocked medications in the clear medication cabinet. These items were properly secured at the time of the visit. At 10:44 a.m. the LPA observed unlocked kitchen knife cabinet, which was locked at the time of observation. At 10:52 a.m. the LPA observed an unlocked door leading to the garage and laundry area containing laundry detergent, disinfectants, and other chemicals. At 10:54 a.m. the LPA observed a kitchen cabinet with unsecured scissors which were properly secured at the time of the visit. Kitchen hot water measured 113.3 degrees Fahrenheit at 11:03 a.m. INFECTION CONTROL: During today’s visit, the LPA spoke with the Administrator regarding the facility’s infection control practices. Upon entry, the facility had a central entry point for symptom screening, temperature checks, and sanitation station. The LPA observed an adequate supply of Personal Protection Equipment (PPE) and the facility is able to obtain additional supplies as needed. 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 administrator was also advised that all staff need to be cleared before entering the facility. The following recommendations were made: - Appropriate signage to remind staff and residents of hand washing hygiene, visitation policies and procedures etc. - Posting Provider Information Notices (PINs) and educating staff, residents, and families on changing policies and procedures from the Department. In addition to obtaining and displaying the departments Let Me Know poster. -Continue Screening visitors and Staff and ensure visitors and staff continue following masking guidelines. 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.