Routine inspection·August 27, 2022

On 8/27/2022, Licensing Program Analyst (LPA) Lourdes Montoya conducted an unannounced annual required visit with a primary focus on Infection Control measures using the new CARE Inspection Tool. Upon arrival at the facility, LPA Montoya called the facility, spoke with Administrator Laureana Lacanilao and conducted a risk assessment. Based on the assessment, the facility is clear of Covid-19 infection. LPA met with Administrator Laureana Lacanilao and explained the purpose of today’s visit. Area Manager JM Demafelix arrived later and joined the visit. The facility is licensed for six (6) non-ambulatory residents which six (6) may be bedridden and a hospice waiver for two (2) residents; prefers to serve elderly age 60 and above. The facility is a single-story structure located in a residential neighborhood. The facility consists of a foyer, kitchen, dining area, living room, fire place, office area, laundry room, five (5) resident bedrooms, one staff bedroom, three and a half (3 1/2) bathrooms (located in resident bedrooms), one shared bathroom, two-car garage and a covered front patio. The facility does not handle residents cash resources. Facility annual fees are current during today’s visit. LPA Montoya toured and inside and outside grounds of the facility with Administrator Laureana Lacanilao. 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 was 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. The water temperature measured 112.4 degrees F. A comfortable temperature of 75 degrees 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, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. The facility has (2) fire extinguishers that were charged, smoke detectors, and carbon monoxide were operable. The facility conducted a Fire/Safety Drill on 8/11/22. A working telephone remains (310-328-6086 available. During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for residents, staff and visitors, and 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. The facility has an approved Mitigation Plan Report on file with CCLD. Advisory Notes - Technical Assistance were issued, please see LIC9102-AN. The following deficiency were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct the deficiency may result in civil penalties. Exit interview conducted and appeal rights discussed. A copy of this report and appeal rights provided to Area Manager JM Demafelix.