Routine inspection·May 20, 2021

Licensing Program Analysts (LPAs) Brian Balisi and Martha Guzman-Chavez initiated a Required Annual inspection with focus on Infection Control today. LPAs met with Emma Arutiunian and explained the reason for the visit. There are (6) bedrooms for residents and (1) bedroom for staff use only. Between 11:30am - 1:00pm The physical plant was toured inside and out with House Manager. LPAs observed wired smoke and carbon monoxide detectors throughout the facility. Fire extinguishers located in the kitchen. All rooms are set up with beds, night stands, comfortable/appropriate chairs, chest of drawers and closet space. Lighting in the rooms appeared adequate at the time of the visit. All rooms have overhead lighting. Bathrooms are equipped with grab bars and non-skid materials. Hot water tested in the bathrooms measured between 106 - 108.3 degrees F. LPAs observed an adequate supply of perishable and non-perishable foods in the fridge. Medications were stored in a file cabinet by the front room. Sharp objects and knives were stored in a locked drawer to the left of the kitchen sink. LPA observed a sufficient supply of non-perishable foods and dried goods stored in the pantry. Emergency food supply was stored in this location as well. LPA did not observe any cleaning supplies stored in the kitchen. At 11:45am LPA observed staff cleaning the common areas. The supply of dishes was observed to be adequate at this time. Continued on 809-C The common areas were appropriately furnished, and lighting was adequate at the time of the visit. At 12:28pm LPAs observed (2) resident sitting in living room watching television. There is an area in the side of the house with outdoor furniture. This facility shares a lot with Bassett Assisted Living #197609920. Exit passageways were clear of hazards and obstructions. Between 1:30pm - 3:30pm LPAs did not observe a sufficient amount of the following: Signs that are posted throughout facility to promote hand washing , cough / sneeze etiquette, and physical distancing and signs that are posted throughout facility to encourage residents to report acute respiratory illness to staff. Emma also informed LPAs that not all staff have been fit tested for N95 respirators. LPAs advised Emma to post additional signs throughout the facility and LPAs will provide Emma with information and resources to have all staff fit tested for N95 respirators. Pursuant to Title 22, Division 6, facility observed to be compliant with regulation. No corrections needed at this time. Exit interview was conducted with house manager and a hard copy was issued via email.