Routine inspection·September 30, 2021

On 9/30/2021/21, Licensing Program Analysts (LPA) Stephanie Cifuentes and Gail Johnson conducted an unannounced annual required visit with a primary focus on Infection Control measures using the new CARE Inspection Tool. LPA met with administrator Ivan Bravo and explained the purpose of today’s visit. The facility is an RCFE licensed for six (6) non- ambulatory client. Currently, there are (2) two non-ambulatory residents residing in the facility, all 60 or older. The facility is a one-story structure located in a residential neighborhood. It consists of the following: four (4) resident bedrooms, with three bathrooms, living room, dining room, kitchen, outside laundry room. No weapons are stored in the premises. Kitchen was inspected and observed to be clean and operational. A 2-day supply perishable and 7-day supply of non-perishable foods are present in the facility. LPA and Administrator toured the physical plant. There were no bodies of water or obstructions on the premises. Beds and bedding supplies were in good condition, adequate lighting provided, storage for client personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were clean and operational. LPA observed the facility to be sanitary and appropriately furnished at the time of visit. Cleaning supplies and toxins, were stored in the laundry room and sharps objects are stored in locked kitchen drawers, locked and not accessible to clients. The kitchen was inspected and there is a 2-day supply of perishable and a 7-day supply of non-perishable food available, maintained properly. Two (2) fully charged fire extinguishers were kitchen and backyard. During the visit, LPA observed the facility infection control practices. LPA observed screening protocol for visitors, staff, and residents, sanitizing stations in common areas and restrooms. LPA observed staff were wearing face coverings, All mandated inspection control posters were posted. The following deficiencies were noted during the visit: At 11:17AM water temperature in kitchen and bathroom 1 was over 143 degrees Farenheit. See 809-D Advisories are on attached 9102 An exit interview was conducted, and a copy of this report was provided to Ivan Bravo, Administrator.