Routine inspection·August 22, 2022

On 8/22/2022, 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, LPA Montoya called the facility, spoke with Licensee Angelique Gradney and conducted a risk assessment. Based on the assessment, the facility is clear of Covid-19 infection. LPA met with Facility House Manager (HM), Nelson Ortega, who granted access and allowed LPA to enter the facility to conduct an annual inspection. Administrator Virginia Asis joined the visit shortly after. Three clients and two caregivers along with the administrator were present in the facility during this inspection. One resident was out for a doctor's appointment. Facility is licensed to serve 6 clients age range 60 and over. Approved for 6 non-ambulatory of which 2 may be bedridden, bedroom#3 is cleared for bedridden; approved for hospice waiver for 6 residents. The Annual Licensing Fees are current. Administrator Virginia Asis' administrator’s certificate #6035815740 expires 9/8/2023. The home consists of two (2) floor levels: the first floor consists of 3 resident bedrooms all of which are shared rooms, 2 restrooms, kitchen, dining room, living room, and attached 2 car garage. The second floor consists of 3 bedrooms occupied by staff. LPA Montoya toured and inside and outside grounds of the facility with HM Nelson Ortega and Administrator Virginia Asis. 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 151.1 and 126.9 degree Fahrenheit in resident bathrooms on the first floor. A comfortable temperature 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. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. The facility has (2) fire extinguishers that were last serviced on 2/23/22; smoke detectors, and carbon monoxide were operable. The facility conducted a Fire/Safety Drill on 7/23/2022. A working telephone 310-316-0001 remains available. During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for 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. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA observed a deficiency and issued a citation on LIC 9099D. Exit interview was conducted and a copy of this report and Appeal Rights were provided to House Manager Nelson Ortega.