Routine inspection·August 18, 2022

Licensing Program Analyst (LPA) Alma Gonzalez conducted an unannounced Annual Required / Infection Control Visit to the above facility. LPA was met by Ok Hee Kim , Administrator and the purpose of today’s visit was explained. The facility is licensed to serve (6) Non-Ambulatory residents ages 60 and above and hospice waiver for (2). There are currently (0) residents on hospice. There are currently (4) residents in the facility . The facility consists of : 4 resident bedrooms, 4 bathrooms (1 bathroom is for visitor use), kitchen, family hall with a prayer room and recreation area, dining room, laundry room located inside the kitchen area. LPA and Administrator Administrator Ok Hee Kim toured the entire facility inside and out. Documents are posted as mandated. All resident rooms were checked and mattresses and bedsprings are in good repair, adequate lighting and closet space observed. All resident bedrooms contain the mandated furniture. Sufficient toiletries, linens towels and bedding for residents. LPA found the facility to have a comfortable temperature at time of visit. The bathrooms are clean, sanitary and operational with grab bars and non-skid mats in place. First aid kit is fully stocked with manual, smoke detectors and carbon monoxide detector were in compliance and operational. No firearms are stored at facility and no bodies of water present. Medications are stored, locked and inaccessible to residents in a locked file cabinet. All disinfectants, toxins, knives and cleaning solutions were locked an inaccessible to residents. Food supply was adequate for 2-day perishable and 7-day non-perishable. Hot water temperature is 115 degrees Fahrenheit, linens and personal hygiene supplies are adequate, hazardous toxins and/or sharp items are inaccessible to clients, Exit, walkways and/or passageways, are free of debris and/or hazards. Physical plant inside and outside was in good repair at the time of the visit. The following were observed/inspected: COVID-19 Infection Control Practices (including signs) were observed at the entrance of this facility, and in all common rooms bathrooms and hallways. Facility is conducting COVID-19 screening for all visitors. Residents are able to use a designated isolation room that will be used as isolation room if a COVID-19 positive case should arise. 30 day supply of medication for residents Facility has an adequate amount of PPE and facility has enough PPE for approximately 3 months . Residents were socially distanced according to local public health guidelines. Staff responsible for direct care and supervision were observed wearing masks. Hand Sanitizer: Available throughout the facility for resident/ staff use. High touch areas are disinfected once a day and as needed. The resident's temperature is checked and logged daily and if they are exhibiting any symptoms. Staff temperatures are checked and logged daily and if they are exhibiting any symptoms. Staff and residents are tested every as needed or if exhibiting any COVID-19 symptoms. All residents and staff are fully vaccinated and have received both booster vaccines for COVID-19. According to the California Code of Regulations, LPA did not observe any deficiencies, therefore no citations were issued at this time. An exit interview conducted with Administrator Ok Hee Kim , Administrator and copy of report provided.