Post-licensing visit·December 13, 2022

Licensing Program Analyst (LPA) Galarza conducted an unannounced Post Licensing visit. LPA explained the purpose of the visit to staff Belen Taico. Administrator Robin Aquino and Director of Assisted Living Stephany Perez were explained the purpose of the visit telephonically. The facility is a single story home located in a residential neighborhood licensed for six (6) non-ambulatory residents; of which one (1) may be bedridden. The facility has a hospice waiver for four (4) residents. The last emergency drill was conducted on 10/20/2022. Administrator certificate expires 11/14/2023. OBSERVATIONS: The facility does not have a copy of the correct license. The previous licensee's license was posted and filed in a facility binder. Director of Assisted Living stated the corporate office has the license. Ms. Perez emailed staff a copy. It was printed and posted during the visit. There are two (2) residents receiving hospice services. Visitors are screened at the facility entrance. COVID-19 Infection Control Practices and signs were observed in the main entrance and bathrooms. Adequate supply of Personal Protective Equipment (PPE's) was observed. The interior and exterior physical plant was inspected. Exit doors are free of any obstruction. Smoke and carbon monoxide detectors were tested and operational. A posted Emergency Disaster Plan was observed. Four (4) centrally stored client medication records were reviewed. Staff were observed wearing mask. Residents were not observed wearing masks due to cognitive impairment. The kitchen was inspected and has sufficient supply of 2 day perishable & 7 day non-perishable food. Sharps/knives and toxins were locked. Staff have criminal background clearance. Resident files were reviewed. Three (3) out of four (4) resident files did not have new Admission Agreements issued by this licensee. The files had Admission Agreement contracts of previous licensee. Per California Code of Regulations, Title 22, deficiencies were observed. See LIC 809D. Exit interview was conducted with staff Belen Taico. A copy of the report and appeal rights were issued.