Routine inspection·April 28, 2022

Licensing Program Analyst's (LPA's) Vasallo and Pena conducted an annual required visit. LPA's met with Administrator, Monica Aguilera and explained the reason for the visit. LPA's used the infection control tool to evaluate the facility. LPA's observed the physical plant, COVID-19 procedures, reviewed residents' medications and records, observed food supply, and reviewed staff records. The facility cares for elderly residents and is approved for 3 hospice residents. There are currently 2 residents on hospice. All resident bedrooms were toured. Each bedroom has a bed, linen, dresser, light, and sufficient closet space. The resident bathrooms have the required grabs bars and non-skid mat. The hot water was 116.6 degrees which is within the required 105 - 120 degrees. Cleaning supplies are inaccessible to residents. The kitchen was inspected. There is sufficient perishable and non-perishable food. All the appliances are clean and seem to be operating properly. The common areas include the living room and dining area. These areas are clean and have the required furniture. There is a screening station at the entrance of the home which has PPEs and a thermometer to screen visitors. Staff document resident temperatures daily and require visitors to sign in. Facility currently has at least a 30-day supply of PPEs. Visitation is allowed in bedrooms, common areas and outside patio. LPA reviewed 6 resident records to confirm emergency contact is updated. Staff records were reviewed to confirm health screenings, training and fingerprint clearances. Staff #1 (S1) did not have a health screening on file. LPA reviewed 6 residents' medications. Medications are documented properly and given as prescribed. Per California Code of Regulations, Title 22, the deficiency observed during the visit is documented on the attached 809D. Exit interview held. A copy of the report and appeal rights were provided to Administrator.