Routine inspection·July 28, 2021

Licensing Program Analyst (LPA) Jey Cardenas conducted an unannounced required annual visit with a primary focus on Infection Control measures using the new CARE Inspection Tools. Upon arrival at the facility, LPA Cardenas called Administrator, Evangeline Agatep; LPA conducted a risk assessment over the telephone and explained the purpose of todays visit. Based on the assessment, the facility is clear of Covid-19 infection. LPA verified that the facility has an approved mitigation plan report. Facility is licensed to serve 174 non-ambulatory residents ages 60 and above. Dementia special program- Hospice Waiver approved for three (3) residents. LPA met with the administrator and they both toured the inside and outside grounds of the facility. LPA was properly screened for Covid-19 symptoms and temperature was checked. The above facility is a two-story commercial building. the facility consisted of the following : The first floor Lobby/receptionist area, business office/ medication room/ record office, Administrator's office, 34 bedrooms and bathrooms, emergency supply room, beauty salon, storage rooms, 3 living rooms, dining rooms, kitchen, resident's private laundry room/commercial laundry room, activity room, recreation/activity director's office, men and women public restrooms, employee's lounges, men and women employee's restrooms, linen room, housekeeping supply room, patios, shaded area, indoor/outdoor activity area, and gated security parking lot. The second floor consisted of: 52 resident's bedrooms and bathrooms, men and women public restrooms, resident's private coin laundry room, TV room, library/living room, game room, storage rooms. During the tour, LPA observed the facility’s infection control practices. LPA observed a sanitizing station at the facility entrance; visitors log with Covid-19 screening and temperature log, and records of daily Covid-19 screening and temperature checks of residents and staff. PPE supplies are readily available to staff, and an additional 30-day supply of PPE was observed. Sufficient paper, cleaning, and disinfecting supplies were observed. The facility’s designated visitation area is the common space on first floor/ outside shaded area located on the front of the facility. LPA observed all staff wear a face covering. LPA observed required postings throughout the facility. Resident rooms were inspected. Beds in shared bedrooms are 6 feet apart/3 feet head-to-toe apart. Beds and bedding supplies were in good condition, adequate lighting provided, storage for resident personal belongings was observed. Resident bathrooms were checked toilets and water faucets worked properly, grab bars were secure, the shower was free of mold/mildew, and a non-skid mat was in place. The water temperature measured between 105 degrees to 120 degrees F in resident bathrooms that were inspected. Comfortable temperature was maintained in the facility. LPA toured the kitchen area and observed a two-day supply of perishable and a seven-day supply of non-perishable food. Toxins were kept in a locked storage. Centrally stored medications were observed to be kept safe and locked and inaccessible to residents in care. The First Aid kit was available and fully stocked with tweezers, scissors, and non-contact thermometer. The facility is equipped with fully charged Fire Extinguisher throughout the facility; fire extinguishers are inspected annual, last inspection was conducted on 07/22/2021. The facility currently has 14 residents with memory care needs. The facility provides structured activities to accommodate all residents. Potentially dangerous items, including sanitizers, are kept inaccessible to residents with dementia. There are no security bars or weapons on the premises. Outside grounds were toured, and no bodies of water were observed. Walkways around the home were clear of hazards. Common areas were clean and clear of hazards; doorways were free of obstructions. Advisory Notes with technical assistance were issued. 1. LPA did not observe printed copies of CDSS PINs made available to residents/ staff. An exit interview was conducted, no deficiencies were cited during this visit, and a copy of this report was provided to administrator.