Routine inspection·February 9, 2023

Licensing Program Analyst (LPA) Christine Wong conducted an unannounced annual required visit. LPA met with House Manager/ Cynthia Tadeo and explained the reason for the visit. LPA used the infection control tool to evaluate the facility. LPA observed the facility plant, COVID-19 procedures, reviewed residents' medications, observed food supply, and reviewed resident and staff files. The facility is located on top of the hill and its a residential neighborhood area. The facility includes staff office, laundry room, dining area, common area/TV room, staff bathroom, six residents bedrooms and six resident bathrooms and a detached garage. All 6 resident bedrooms were toured. Each resident bedroom has one bed, one chair, one dresser, required bed linen and furniture and sufficient lighting and closet space. All 6 resident bathrooms were toured also, Each resident bathroom have the required grabs bars and non-skid mats. The hot water temperature in all 6 resident bathroom were tested between 108.3 and 111.9 F. which is with the Tittle 22 regulation. The refrigerator in the kitchen and kitchen cabinet has 2 days perishable and 7 days non-perishable food supply. All the appliances in the kitchen are clean and working properly. All sharp knives and utensils are stored and locked in the medication cabinet and its inaccessible to resident. All the cleaning supplies are locked under the sink. The common areas such as TV room and dining area are clean and have the required furniture. The front yard is maintained well. Exits and passageways are free of obstructions. . LPA reviewed 3 resident files to confirm emergency contact is updated . LPA also reviewed 2 staff files to confirm health screenings and fingerprint clearances and they all have updated health screening in their personnel file and they both fingerprint cleared too. LPA also reviewed 3 residents' medication and they all seemed accurate and updated. (See LIC 809C continuation) Facility is currently following COVID 19 recommendations regarding COVID 19 signs throughout the facility, The facility is disinfected every hour. Resident's bathrooms have sufficient soap, paper towels, and signs, Facility has sufficient for 30 days supply of PPE. LPA did not observe any deficiencies during the visit. Exit Interview Conducted. The copy of the report was provided to House Manager Cynthia Tadeo