Routine inspection·June 26, 2022

On 06/26/22, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced annual required visit with a primary focus on Infection Control measures using the CARE Inspection Tool. LPA met with assistant administrator Christopher Bundalian and explained the purpose of today’s visit. The facility is licensed to operate for six (6) non-ambulatory elderly residents ages 60 and above. The facility is approved for two (2) hospice residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: six (6) resident's rooms, three (3) common bathrooms, living area, dining area, kitchen, a staff room, an office and outside covered patio area. LPA toured the physical plant. There were no obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for resident personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the visit. Bathrooms were found to be within Title 22 regulations and were operational. The water temperature measured 109.9 degrees F. A comfortable temperature of 83 degrees was maintained in the facility. LPA observed the facility to be appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and sufficient perishable and non-perishable food was maintained adequately. The facility has two (2) fire extinguishers that were charged, smoke detectors, and carbon monoxide were operable. LPA reviewed Medication Administration Records (MAR) revealed to be accurate and maintained in order. A working landline telephone remains available. Evaluation Report continues on LIC 809-C DEFICIENCIES: During the inspection visit at 9:10 am, LPA observed uncleaned and unsanitary microwave oven. At 9:16 am LPA observed a powder bleach on top of the bathroom sink accessible to residents in bathroom #2. At 9:17 am, LPA observed a non-working toilet in bathroom #2. INFECTION CONTROL: During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, sanitizing stations in common areas and restrooms. LPA observed staff were wearing face coverings, LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. A review of staff tests and residents' vaccination along with daily temperature checks were conducted. The facility has an approved Mitigation Plan Report on file with CCLD. Based on interviews, observation, and record reviews the licensee violated the California Code Regulations (CCR) of Title 22, Division 6, Chapter 8. Deficiencies are issued and an exit interview is conducted with Christopher Bundalian. A copy of this report is provided along with the appeal rights.