Routine inspection·September 9, 2021

At 10:30 a.m., Licensing Program Analyst (LPA) Emily Peraldi arrived at the facility unannounced to conduct a required annual visit. LPA was greeted and screened by staff, DIANA SO. The Administrator JUSTIN LEVI arrived at the facility at 10:35 a.m. This annual had a specific emphasis on infection control practices and procedures. Between 10:50 a.m.- 11:30 a.m., LPA 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. OUTDOOR SPACE: At 10:55 a.m., LPA observed the back patio, which has a covered outdoor area for resident use. There is a gate on the side of the facility designated for an emergency exit. Passageways were free and clear from obstruction. KITCHEN: At 10:50 a.m., LPA observed the kitchen/dining area. Knives are stored in a locked cabinet. Kitchen appliances are in operable condition. The facility has a sufficient supply of perishable and non-perishable food. At 11:16 a.m., hot water measured at 113.9-degree Fahrenheit. Medications and first aid kits are located in a locked kitchen cabinet. BEDROOMS: LPA observed resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Inside temperature was maintained at a comfortable level. RESTROOMS: Restrooms are relatively clean and sanitary and in operating condition with grab bars and non-skid mats. At 11:18 a.m., hot water measured at 115.2-degree Fahrenheit. Continued on LIC 809-C. Continued from LIC 809. COMMON AREAS: LPA observed common area to be relatively clean and properly furnished. LPA observed the fire extinguisher to be fully charged and last serviced on 12/29/2020. INFECTION CONTROL: During today’s visit, the LPA spoke with the Administrator regarding the facility’s infection control practices. Upon entry, the facility has a central entry point for symptom screening, temperature checks, and a sanitation station. LPA observed a 30-day 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 has not had a confirmed case of COVID-19 at this time; however, the facility’s policies and procedures as it pertains to infection control are adequate. Between 10:50 a.m. - 11:30 a.m., LPA conducted Infection Control mitigation module with Administrator. No deficiencies were observed at this time. Exit interview conducted. Report issued and a copy of the report was provided via email.