Routine inspection·May 24, 2021

Licensing Program Analyst (LPA) Ulysses Coronel conducted an unannounced Annual required visit with a primary focus on infection control measures. LPA was met by administrator Oscar Lechuga and the purpose of today’s visit was explained.The facilioty is licensed to serve residents age 60 and over.The facility has been approved for six (06) non ambulatory residents. Approved to retain one (01) hospice resident. There are currently 3 residents , all 3 residents are non-ambulatory of which 2 are diagnosed with dementia.. The facility consists of a kitchen, two dining areas, living room, a staff bedroom, three (3) resident bedrooms, two (2) bathrooms (one bathroom located in bedroom#3), backyard patio, washer/dryer located outside on the left side of the house, shed, and a garage. LPA and staff toured the physical plant. There are no bodies of water or firearm/ammunition on the premises. All client rooms were checked. Beds and bedding were in good condition, adequate lighting provided, storage for client personal belongings was observed. Walls and floors were in good repair. 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. The water temperature measured 119.8 F. A comfortable temperature is maintained in the facility. LPA observed the facility to be clean and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning agents, toxins, and sharps were inaccessible to clients. The kitchen was inspected and there is a enough perishable and non-perishable food available which is stored properly. Fire extinguisher was charged, smoke detectors and Carbon Monoxide were operable. During the visit, LPA observed the facility infection control practices. LPA observed screening protocols for visitors, staff and residents, sanitizing stations ( Located in common areas and restrooms). LPA observed staff and residents were wearing face coverings, an isolation room and required postings throughout the facility. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). LPA advised the Administrator to continuously monitor the Centers for Disease Control (CDC) website and Community Care Likening Provider Informational Notices (PIN) for any updates relating to COVID-19 guidance. During today’s visit LPA observed that the staff room is being used by R1 as their bedroom, the administrator stated that R1 has been using the staff room for less than 2 months now. California Code of Regulations, Title 22. is being cited, please see LIC809D. Exit interview held. A copy of the report and appeals rights was provided to Oscar Lechuga.