Routine inspection·February 3, 2022

Licensing Program Analyst (LPA) Ana Soto and Jeremiah Randle conducted an unannounced Annual required and infection control visit to the above facility. LPA's were met by Sara, House Manager and spoke with DianaTekeian, administrator via phone and the purpose of today’s visit was explained. There are currently (2) residents in the facility . (0) residents are ambulatory and (2) are non-ambulatory. The facility is a single story structure with a ramp and front porch located in a residential / commercial neighborhood. The facility is located in the back of the building near the alley. It consists (3) bedrooms, (2) full bathrooms, shaded front yard, laundry room and no garage. LPA's and Sara toured the entire facility inside and out. Documents are posted as mandated. See something say something and oxygen in use posters were not posted in the facility. Bedrooms 1 & 2 are occupied by residents and contain the mandated furniture. Bedroom 3 is vacant . The (2) bathrooms are clean and operational. First aid kit is fully stocked with manual, smoke detectors and carbon monoxide detector are inter connected and were in compliance and operational. No firearms are stored at facility and no bodies of water present. Medications are stored, locked and inaccessible to residents. Residents Medications did not have a centrally stored list and staff & resident files were not available for inspection. Ample supply of perishable and nonperishable food, hot water temperature is 120 degrees Fahrenheit, linens and personal hygiene supplies are adequate, hazardous toxins and/or sharp items are inaccessible to residents, 1 fire extinguisher is fully charged. Exit, walkways and/or passageways, front and back yard are free of debris and/or hazards. The facility is in good repair. During the visit, LPA observed the facility infection control practices. LPA observed a sanitizing station at the facility entry, visitors are logged and temperature checked, sanitizer/soap in the staff bathroom. LPA observed staff and residents wearing masks, resident private rooms will be converted to isolation rooms (if needed) and missing isolation postings and other posting were posted. throughout the facility. The residents temperature's are checked and logged once a day. PPE's were not available for inspection. Isolation cart was missing. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did observe deficiencies, therefore citations were issued. An exit interview conducted with Sara Tekeian, Administrator and copy of report provided via email.