Routine inspection·April 6, 2022

On 04/06/2022, 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 was met by staff (S1-S2) and later joined by Administrator Melanie Tallada and explained the purpose of today’s visit. The facility is licensed to serve six (6) elderly residents ages 60 and above of which five (5) can be non-ambulatory, one (1) can be bedridden in room 4 and two (2) can be on hospice care. The facility is a single-story structure located in a residential neighborhood. It consists of the following: four (4) resident's rooms, two (2) bathrooms, living area, dining area, kitchen, and outside shaded patio area. LPA and Administrator Melanie Tallada toured the physical plant. There were 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 operational. The water temperature measured over 120 F in both bathrooms and kitchen sink. See 809D page for the deficiencies. A comfortable temperature was maintained in the facility. There is an attached garage used for storage only. The garage contains an additional refrigerator/freezer for food. The garage also is where the washer and dryer are located. Evaluation Report Continues on LIC 809-C LPA observed the facility to be appropriately furnished at the time of visit. LPA observed unlocked cleaning supplies and toxins under both bathroom sinks. See 809D page for the deficiencies. The kitchen was inspected and there is sufficient perishable and non-perishable food available properly maintained. The facility does their grocery shopping every other Friday or as needed. Two (2) fire extinguishers were charged with one in the garage and one in the kitchen area, smoke detectors and carbon monoxide were operable. A review of Medication Administration Records (MAR) was maintained in order and accurate. There was a first aid kit available located with the linens in a closet. 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 the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. Advisory Notes – Four (4) Technical Assistance were issued, please see LIC9102-AN. Three (3) deficiencies were cited during this inspection visit. See 809D page. An exit interview was conducted and a copy of this report was provided to Melanie Tallada.