Routine inspection·March 18, 2022

Licensing Program Analyst (LPA) Martessa Brown conducted an unannounced Annual required visit with a primary focus on infection control measures. LPA was met by Rosario Evangelista, House Manager and the purpose of today’s visit was explained. LPA was later met by Jehn Dema Felix-Manager. The facility is licensed to serve the Elderly Residential (RCFE) ages 60 years and above. Licensed capacity is for 6 non-ambulatory and 1 bedridden. They are approved for 4 hospice waivers. There are currently 4 residents that were present in the facility. They have 4 bedridden residents . All The facility is a single-story structure located in a residential neighborhood on a main street. It consists of the following: 4 bedrooms, 2 bathrooms, family room/dining room, kitchen, living room, shaded area, indoor and outdoor area, laundry room and an attached garage. LPA and staff toured the physical plant. There are no bodies of water or firearm/ammunition on the premises. All residents rooms were checked. Beds and bedding were in good condition, adequate lighting provided. Residents rooms, 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 106.9. F and 110 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. Lic 809-C is on the next page. 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 deficiencies were observed. California Code of Regulations, Title 22, Division 6 and Chapter 8 are being cited on the attached LIC 9099D. Exit interview held. A copy of the report was provided to Jehn Dema Felix, Manager.