Routine inspection·November 3, 2021

At 10:20 am, Licensing Program Analyst (LPA) Melissa Ruiz conducted an unannounced annual inspection at the facility mentioned above. LPA was greeted by staff (S1) who granted access to the home and later met with designee Stephanie Domingo. This is an 9-bedroom, 3-bathroom single story residential care facility for the elderly. A physical tour was initiated at 10:30 am and observed the following: Infection control: Proper signage was observed outside the home and along the main entrance of the facility. Upon entrance, staff took LPA's temperature and was asked to sign-in the visitor’s log but was not asked any infection control questions. Hand sanitizer was available, and trash cans were observed to have closed tight fitting lids. Sufficient PPE supplies were observed. Food Inspection: 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. Sharps, cleaning supplies and medications are centrally stored in and are kept locked. Smoke detectors/carbon monoxide were located throughout the facility. At 10:45 am, they were tested and are functional. Facility maintains a comfortable temperature of 75.0 F. Resident room s: There are five (5) bedrooms designated for resident use, three (3) bedrooms are designated for live-in staff. All bedrooms are properly furnished, clean, and have appropriate bedding and linens. Bathrooms: The hot water temperature measured at 105.0 F. Towels and washcloths are not shared. Extra towels and linens were readily available. Non-skid mats and appropriate grab bars were visible. Garage space was converted to additional bedrooms with storage, permit issued 09/01/2020. Outside areas: LPA toured the outside area of the facility. LPA observed appropriate outdoor furniture, with a covered shaded area for residents. There are no bodies of water. No deficiencies cited. A copy of this report was provided. Exit interview conducted.