Routine inspection·July 21, 2022

Licensing Program Analyst(s) (LPA) Mary Flores and Ashley Calderon conducted an unannounced annual visit with focus on infection control, medication, and food review. LPAs met with Rosalie Sandoval administrator and conducted a tour of the facility. The facility is licensed to serve 60 non-ambulatory residents ages 60 and over with an approved hospice waiver for 5 residents. The facility is a large building located in a residential area, it has 35 shared rooms, and shaded sitting area. Facility does not have a kitchen and per the plan of operation they receive food prepared in their sister facility for all resident meals. Facility has a sprinkle smoke detector system throughout and carbon monoxide detectors were observed. LPAs conducted a tour of the facility with Rosalie Sandoval administrator and observed the following: Dining/Activity area was observed to have sitting set to allow for social distancing. Signs and posters were observed upon entering the facility and the office area. Medication is kept in the medication room and under lock. Cleaning supplies, PPE supplies, and emergency food supplies were observed locked in a storage room. No sharps were observed.The following rooms were observed, rooms #4,6,13,19,31,32 each room had sufficient lighting, bedding supplies, and furniture and a shared toilet. Facility has 3 common bathroom/showers(B), skid mats and grab bars were observed and B#1 water temperature was tested at 114.9 degrees F, B#2 was tested at 113.4 degrees F. unidentified animal droppings were observed in the corners of the showers, and B#3 was tested at 110.1 degrees F., which is within the required 105 - 120 degrees F. Medication and files were reviewed for 4 residents and 4 staff files. Administrator certificate was observed # 6012456740 expiration date 1/24/24. Facility is maintaining Infection control recommendations per guidelines and recommendations. Exit interview was conducted with Rosalie Sandoval Administrator and a copy of this report was provided.