Routine inspection·June 18, 2021

Licensing Program Analysts (LPAs) Nicol Wesley and Luis Mora conducted an unannounced Required 1 year inspection at the facility and met with Administrator Luzviminda Bulosan and explained the purpose for todays visit. Prior to the visit LPA Wesley conducted a risk assessment for on-site inspections. The facility phone number is 562 466 9268. The facility consist of four resident bedrooms, two bathrooms, one of which is in bedroom # four, a living room, dining room, kitchen and patio located in the back yard, unattached garage(storage and overflow of food). During the visit the Infection control domain was used and the following areas were observed/inspected: The facility had all postings at the front entrance, bathrooms, and throughout the facility. Hand sanitizing gel and masks were located at the entry of each room. A Pre screening area with PPE supplies was observed upon entry into the facility. The facility was reminded to review and comply with PIN 21-28 ASC. LPAs conducted a complete tour of the facility, and observe the supply of food. Resident medications, and medication logs were reviewed. The smoke detectors/carbon monoxide detector are operable. LPA observed one fire extinguisher in the kitchen. The water temperature was tested and measured 114.6 degrees F. LPA Wesley received a copy of the facility mitigation plan report at the time of visit. Administrators certificate for Luzviminda A Bulosan #6025272740, expires on 09/25/2022. There were no deficiencies cited. Exit interview conducted.