Routine inspection·February 24, 2022

At 9:15 a.m., Licensing Program Analyst (LPA) Melissa Ruiz and 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 Administrator Lucine Meliksetyan. This is a 4-bedroom, 3-bathroom single story residential care facility for the elderly. A physical tour was initiated at 9:30 a.m. and observed the following: Infection control: Some signage was observed outside the home and along the main entrance of the facility. Upon entrance, staff took LPA's temperature but was not asked to sign-in the visitor’s log or 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. Sharps, cleaning supplies and medications are centrally stored in and are kept locked. Smoke detectors/carbon monoxide were located throughout the facility. At 10:20 a.m., they were tested and are functional. Fire Extinguisher has a date of purchase of 10/13/2021. Resident room s : All bedrooms are properly furnished, clean, and have appropriate bedding and linens. Bathrooms: The hot water temperature measured at 113.6 F. Extra towels and linens were readily available. Non-skid mats and appropriate grab bars were visible. Living Room: There is a large black leather sectional sofa that is showing extreme signs of wear and tear. All of the seat cushions are peeling. Garage there is an attached garage that leads to the outside. It is kept locked. (cont. on 809-C) 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. Care and supervision: LPAs observed one staff to 6 residents on duty. One staff is tasked with providing care and supervision, which include by not be limited to changing residents, assisting residents with toileting needs, assistance with medications, transfers, etc. Staff are also tasked with screening visitors as they come into the facility. One staff is unable to meet all these needs and keep any eye on everyone. Deficiencies were issued per CA code of Regulations Title 22 or Health and Safety Code. See 809D's included with this report. Report delivered. Appeal rights issued. Exit interview conducted.