Routine inspection·July 22, 2021

At 3:42 p.m. Licensing Program Analysts (LPAs) Melissa Ruiz, Angela Panushkina and Licensing Program Manager (LPM) Nichelle Gillyard conducted an unannounced annual inspection at the facility mentioned above. Team met with caregiver Martha Maria Reyna who granted access to the home. This is a 6-bedroom, 4-bathroom single story residence that includes a living room, dining area, kitchen, and dining area. LPA toured the entire facility with the Administrator Sona Muradyan who arrived at approximately 3:50 p.m. and observed the following: Infection control: LPA reviewed approved facility mitigation plan to make sure licensee was following current infection control recommendations. Upon arrival, the team was not screened by the caregiver and was not asked any infection control questions. Staff was unable to take LPAs temperatures. The team had to prompt and guide the caregiver through the screening process. Food Inspection: LPA conducted a food inspection tour. Currently the licensee has a offsite food waiver in which a outside food vendor provides meals for the residents. LPA observed there to be insufficient stock of one-week non-perishable foods. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. Garbage cans have tight fitting covers in the kitchen. Smoke detectors were checked and are hardwired throughout the facility. Smoke detectors and carbon monoxide are observed to be operational. Resident room s: There are 6 bedrooms designated for resident use and have sufficient lighting. One bedroom is designated for live-in staff. All bedrooms are properly furnished, cleaned and have appropriate bedding and linens. Auditory alarms are placed on each door. The facility has dementia residents in care. Bathrooms: LPA toured resident bathrooms and checked to make sure bathrooms were clean and in good repair. The hot water temperature measured at 117.3F. LPA observed appropriate hand washing signs posted in each bathroom, grab bars and non-skid mat. Towels and washcloths are not shared. Residents have sufficient amounts of supplies for personal hygiene which is provided by the Licensee. At 4:05 p.m. LPA observed cleaning products/chemicals accessible to residents. Outside areas: LPA toured the outside area of the facility. LPA observed appropriate outdoor furniture, with a covered shaded area for clients. There are no bodies of water which is unsecured. The garage is detached to the home and is kept locked inaccessible to clients. Laundry service: There is enough linen available to change weekly or more if need. Medications are in a centrally stored and locked. Care and supervision: Team observed one staff to 6 residents on duty. One staff is tasked with providing care and supervision, which include by not limited to changing residents, assisting residents with toileting needs, assistance with medications, tranfers, etc. Staff are also tasked with screening visitor as they come into the facility. One staff is unable to meet all of these needs and keep any eye on everyone. A resident voiced a concerned that staff does not respond when needed at night after calling several times. Therefore additional staffing is needed. Administrative: LPA collected the Administrators certification, Sample food menu and license from outside food vendor, certificate of liability insurance and LIC 500. Annual fees are current. Deficiencies and Civil penalties were issued per CA code of Regulations Title 22 or Health and Safety Code. See 809D's included with this report. Appeal rights issued. Exit interview conducted.