Routine inspection·December 5, 2022

Licensing Program Analyst (LPA) V. Maldonado conducted an annual required visit. LPA met with caregiver, Ben Garcia and explained the reason for the visit. LPA used the infection control tool to evaluate the facility. LPA inspected the physical plant, observed food supply, COVID-19 procedures, reviewed resident and staff files, and residents' medications. Facility has submitted a mitigation plan and the plan has been approved. Administrator Nina Corsentino arrived shortly and assisted with the visit. The home consists of 3 shared resident bedrooms, 3 bathrooms, a kitchen, dining room, living room, TV room, a shaded patio in the backyard with seating, and All resident bedrooms were toured. Each bedroom has a smoke detector, required furniture, bed linens, and sufficient closet space. LPA observed 2 of 6 resident beds to have bed rails. After review of their files, it was noted that the residents did not have a physician's order for the bed rails. All resident bathrooms were toured and have a shower, toilet, wash basin- all operational during the visit. Bathrooms have the required grabs bars and non-skid mats. The hot water was tested and measured between 110*F, which is in compliance of Title 22 Regulations. The kitchen was toured. All appliances were observed to be operating properly. There was a sufficient amount of 2-day perishable and 7-day non-perishable food. The common areas including the living room and dining room are clean and have the required furniture. There is a carbon monoxide detector in the living room. The facility has auditory devices at all doors in the facility and were observed to be operating during the the visit. Fire extinguishers were observed throughout the facility and observed to have recent inspections and were fully charged. LPA reviewed all resident files and discovered 1 of 4 residents with dementia to not have an updated physician's report or appraisal. LPA reviewed staff files and observed them to be complete including but not limited to first aid certificates, health screenings, proof of training, and proof of fingerprint clearance. (Report continued on LIC809-C...) LPA reviewed all residents' medications and were observed to be documented properly and given as prescribed. LPA observed the facility to have one central entry point for temperature check and COVID-19 symptom screening of visitors, staff, and residents. Sufficient Personal Protective Equipment (PPE) for 30 days was observed at the entrance of the facility and in the garage. All staff in the facility were observed to be wearing proper PPE at all times. Hand washing stations were observed to be fully stocked with liquid soap and paper towels. COVID-19 signage was not observed throughout the facility to promote social distancing and cough/sneeze etiquette. A technical advisory was issued as is a current requirement for COVID-19. Per California Code of Regulations, Title 22, deficiencies were observed and will be cited on the LIC809-D. An exit interview was conducted with Mina Coresntino and a copy of the report and appeal rights were provided.