Routine inspection·June 15, 2021

On 6/15/2021 at 12:50 pm, Licensing Program Analyst (LPA) Lourdes Montoya conducted an unannounced required annual visit with a primary focus on Infection Control measures using the new CARE Inspection Tools. Upon arrival at the facility, LPA Montoya called the facility, spoke with House Manager Ricardo Bernal and conducted a risk assessment over the telephone. Based on the assessment, the facility is clear of Covid-19 infection. Licensee has timely submitted a mitigation plan report pending CCLD’s review and approval. The facility is licensed for two (2) ambulatory and four (4) non-ambulatory, of which two (2) may be bedridden. Facility has two approved hospice waivers. LPA observed six (6) residents of which two (2) are on hospice care. LPA observed two staff on duty during the visit. At around 1:00 pm, LPA met with the House Manager and they both toured the inside and outside grounds of the facility. Administrator Alberto Pimentel, Licensee Michelle Kellogg and Assistant Administrator Kian Pascual arrived later and joined the visit. During the tour, LPA observed the facility’s infection control practices. LPA observed a sanitizing station at the facility entrance and a visitors log. PPE supplies are readily available to staff, and an additional 30-day supply of PPE is stored in the garage; sufficient paper, cleaning, and disinfecting supplies were observed. The facility’s designated visitation area is the back patio in addition to the resident’s bedroom. LPA observed staff and residents maintain 6 feet physical distancing, and each person wears a face covering. LPA observed required postings throughout the facility. LPA reviewed the facility’s surveillance testing records, one out of four staff tested with Covid-19 every seven days. All rooms were inspected. Beds in shared bedrooms are 6 feet apart/3 feet head-to-toe apart. Beds and bedding supplies were in good condition, adequate lighting provided, storage for resident personal belongings was observed. REPORT CONTINUED IN LIC 809C Furniture in the living room are marked or separated, and 6 feet apart from each other. There are no security bars or weapons on the premises. Resident bathrooms were checked, sufficient liquid soap and paper towels were observed. Toilets and water faucets worked properly, grab bars were secure, the shower was free of mold/mildew, and a non-skid mat was in place. The water temperature measured at 114.0 degrees F. in the common bathroom and 114.1 degrees Fahrenheit in the shared bedroom. A comfortable temperature was maintained in the facility. All bedrooms and living room have smoke detectors and they are all interconnected and operational. Carbon monoxide detector located and mounted in the hallway is operational. LPA toured the kitchen area and observed a two-day supply of perishable and a seven-day supply of non-perishable food. Knives were kept in a locked storage cabinet. Centrally stored medications were observed stored in their originally received containers and kept safe and locked and inaccessible to clients in care. The First Aid kit was available. Two fire extinguishers last serviced 2/10/2021 are fully charged. Outside grounds were toured, and no bodies of water were observed. LPA observed the following deficiencies: · Obstructions in outdoor walkways · Toxins accessible to residents · Left side gate is locked with a padlock. Deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted and appeal rights discussed. A copy of this report and appeal rights provided to Assistant Administrator Kian Pascual. Advisory Notes were issued, and Technical Assistance was provided. An exit interview was conducted, and a copy of this report was provided to Assistant Administrator Kian Pascual.