Routine inspection·December 3, 2021

On 12/03/2021, Licensing Program Analyst (LPA) Don Senaha conducted an unannounced annual required visit with a primary focus on Infection Control measures using the new CARE Inspection Tool. LPA met with caregiver Henry Cadenas and was later joined by Administrator Glenda Bustos and explained the purpose of today’s visit. The facility is licensed to operate for six (6) elderly residents ages 60 and above. The facility is approved for six (6) non ambulatory of which one (1) can be bedridden and two (2) can be under hospice care. The facility is a single-story structure located in a residential neighborhood. The facility consists of the following: five (5) resident's rooms, three (3) bathrooms of which one (1) is designated for staff only, a living room area, a dining area, kitchen, receiving or visitation room and an attached garage used for storage only. The washer and dryer is stacked and located in the kitchen and there is a second refrigerator/freezer in the garage. LPA and caregiver Henry Cadenas toured the physical plant. There are no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting provided, storage for resident personal belongings was observed. 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. A comfortable temperature was maintained in the facility. Evaluation Report Continues on LIC 809-C. LPA observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, and toxins were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. There are two (2) fire extinguishers fully charged in the kitchen and the garage. First aid kit was located in the kitchen. Smoke detectors and carbon monoxide were operable. A review of Medication Administration Records (MAR) was maintained in order and accurate. During the visit, LPA observed the facility infection control practices. LPA observed screening protocols for visitors, staff, and residents, sanitizing stations in common areas and restrooms. LPA observed six (6) residents and two (2) staff present during the tour. All mandated inspection control posters were posted. Advisory Notes – Three (3) Technical Assistance were issued, please see LIC9102-AN. Two deficiencies were cited during this inspection visit. See 9099-D page. An exit interview was conducted and a copy of this report was provided to Administrator Glenda Bustos.