Routine inspection·January 27, 2023

Licensing Program Analyst (LPA) Alberto Lopez made an unannounced visit for the purpose of conducting the required annual inspection focused on infection control. On today's visit LPA was greeted by DSP Theresa Kuwashima and Administrator Silvia Castro arrived a short time later and assisted with the visit. Administrator certificate expires 10/14/2024 Last fire drill was on 11/20/2022 LPA discussed infection control practices with Ms. Castro, toured the facility inside and out, reviewed food supply. Temperature measured 117- 119.3 which is within regulatory range. Structure/Physical Plant: The facility is part of a single story home located in a residential area and contains the following: living room, dining room, kitchen with refrigerator, electric oven, dishwasher, sink/faucet, locked storage cabinet for medications and sharps, (4) resident rooms, (1) bathroom; bathroom with shower, toilet and washbasin, Laundry closet with washer and dryer and storage for toxins. (1) Staff room with personal bathroom that are both inaccessible to residents. A front yard and a backyard with shaded/furnished area for resident use. A connected garage inaccessible to residents for storage. The residence is equipped with central air and heating. The following were observed/inspected: · The facility had a universal entrance screening area including a thermometer, PPE supplies, screening logs, and sign-in sheet. · COVID-19 signage was placed in several areas of the facility. Visitors are screened in the main entrance and a log is kept. · LPA was screened for this visit. · Infection control signs and other COVID-19 signs are posted throughout the facility, in the bathrooms, kitchen, and hallway to promote hand washing, cough/sneeze etiquette, and physical distancing. (CONTINUED ON 809C) · PPEs were observed. Facility maintains at least 30-day supply of PPE at facility. · Staff responsible for direct care and supervision were not observed wearing masks initially. · 4 resident medication records were reviewed. · Residents were not observed to be wearing masks but adhering to public health social distance guidelines. Per California Code of Regulations, Title 22, and California Health and Safety Code, there were deficiencies observed during the visit. Please see 809D for details. Exit interview held and a copy of the report and appeal rights was provided to Ms. Castro.