Routine inspection·November 28, 2023

Licensing Program Analysts (LPAs) Cynthia Chan and Sanjay Vaid conducted the required annual inspection. LPA met with Administrator, Christina Matsumoto, and explained the purpose of the visit. The facility is licensed for a capacity of 120 residents ages 60 and over, of which 10 may be bedridden. Rooms #129 - #145 and all first floor rooms (except for rooms #101, #103, #105, #107, #109, and #111) are approved for bedridden. The 3 exterior gates are approved for delayed egress. There is a hospice waiver approved for 20 residents. LPAs conducted the inspection using the Compliance and Regulatory Enforcement (CARE) Tools. The following were observed: Infection Control: The facility staff are using appropriate hand hygiene and wearing gloves while assisting residents. Staff continue to clean and disinfect daily. Facility has sufficient PPE supplies and the Infection Control Plan in place. Operational Requirements: The facility has a dementia care plan to accept or retain residents with dementia. Residents utilizing oxygen tanks have signs posted at the front door. Physical Plant & Environment Safety: The facility is a 2 story building with resident rooms on both floors. The main floor consists of the main lobby, dining room, kitchen, resident rooms, and the memory care unit. The 2nd floor consists mainly of resident rooms and activity rooms. There are no swimming pool or bodies of water on the premises. LPA selected 8 random rooms - (rooms #143, #137, #116, #104, #234, #239, #218, #202) to inspect. The rooms have non-skid mats and the hot water temperature was measured within range of 105-120 degrees F. There are multiple carbon monoxide detectors in each hallway. Planned Activities: Facility has sufficient space to accommodate indoor and outdoor activities. There are planned daily activities and are posted on the monitor. Food Service: There are sufficient food supplies of 2-day perishable and a week of non-perishable items. The food are properly stored in the refrigerator. Disaster Preparedness: The facility has an Emergency Disaster Plan posted with contact numbers and at least 2 relocation sites. There are no deficiencies observed during the visit today. An exit interview was held and a copy of this report was given to administrator Matsumoto.