Routine inspection·June 23, 2021

Licensing Program Analysts (LPAs) Shannan Hansen & Fernandes-Goes conducted an unannounced Annual Required – 1 yr. Infection Control inspection to this facility and was welcomed by Corrine Tanchoco Executive Director & Jocelyn Residence Service Director. There were 80 residents present at the facility of a max capacity of 180 (LG-17 & AL-63). LPAs arrived at the facility and had their temperatures checked and logged. All staff are temperature checked and logged each shift and wear masks. LPAs toured the facility with Corrine Tanchoco Executive Director & Jocelyn Residence Service Director. During tour on 6/23/2021 with Corrine T. ED & Jocelyn RSD facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguishers were found to be last charged on 1/2021 at the time of the visit. A sample of 2 out of 2 Smoke Detectors & Carbon monoxide detectors were found to be operational during the visit. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Facility staff understands that food stored in the kitchen refrigerator must be properly stored as per regulations. Hot water temperature measured upstairs between 118. degrees F and 118.7 degrees F and downstairs between 117.1 degrees F and 118.9 degrees F. within acceptable regulations of 105 to 120 degrees F in 4 of 4 client’s bathroom faucets. There was a supply of cleaners, hygiene products and paper products available for residents. All resident’s bedrooms have lighting & appropriate furnishings. Infection Control: Facility has submitted a mitigation program plan that has been submitted awaiting approval at this time. Posters have been placed at facility. Facility has PPE supply stored in the upstairs and downstairs hallway closets. Residents’ medications are stored and locked. Facility has a 30-day supply of medication for residents. Residents do not wear masks inside the facility. Continue LIC 809-C In addition, facility has a designated area for visitors outside which are being allowed for scheduled visits. Residents have also available zoom and telephone calls when contacting with family members and others. Staff had all PPE training required on file. LPAs reviewed Licensing Information System (LIS) with staff who stated that is corrected and updated at this time. In addition, LPA advised facility to contact Marin County Public Health and DSS/CCL Community Care Licensing immediately if symptoms or COVID-19 + in the facility. Department is requesting a copy of facility Liability Insurance to be submitted to RO Rohnert Park by June 30,2021. There were no deficiencies cited at this time. No citations issued