Routine inspection·February 14, 2022

Licensing Program Analyst (LPA) Fernandes-Goes conducted an unannounced Annual Required – 1 yr. Infection Control inspection to this facility and met with staff Renaud Michaud. Some clients were present at the facility. Some clients at this facility are in day program and/or zoom activities. There are activities planned for clients during the day if they want to participate. LPA arrived at the facility and had her temperature checked and logged into visitor’s binder. During facility tour on 2/14/2022 with staff Renaud facility was found at a comfortable temperature with all exits free from obstruction. Sample of client’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguisher was found to be last charged on 02/2021 at the time of the visit. Carbon monoxide detector wasn’t operational during visit. (see LIC 809-D) Sample test of Smoke detectors was conducted and were operational during this visit. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Food stored in the kitchen refrigerator were properly stored as per regulations on this day at the time of the visit. Toxins are stored in a locked cabinet inside hallway closet. Dangerous items were stored inaccessible to clients. There was a supply of cleaners, hygiene products and paper products available for clients. Client’s bedrooms that were inspected had lighting & appropriate furnishings; mattress pads are available for clients at the facility. Facility hot water temperature in clients' bathroom faucets measured between 107.2 degrees F and 109.2 degrees F in 2 out of 2 faucets within Title 22 acceptable regulations of 105 to 120 degrees F. Disaster Drills have been conducted with the last one being conducted on 1/5/2022. Continue LIC 809-C Infection Control: Facility has submitted a mitigation program plan that has been approved. Posters have been placed at facility, small table with hand sanitizer and other items designated for visitors are at entrance. Staff before coming into work has temperature checked. Facility has PPE supply stored in hallway closet, office room, and garage. There has been no new staff hired or new clients since COVID-19. Clients’ medications are stored and locked in medication cabinet inside office room. Facility has a 30-day supply of medication for clients. Clients are sometimes wearing masks inside the facility, however; staff stated that they are able to wear masks when going on outings. Staff had masks on during this visit. Clients have available zoom and telephone calls when contacting with family members and others. Staff have had all PPE training required on file and staff had N-95 fit testing conducted. Appeal of Rights Given. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal of rights provided. Department is requesting Licensee to update the following documents and submit to CCL by 2/21/2022: LIC 308 Designated LIC 500 Personnel Summary LIC 400 Affidavit Regarding Resident Cash Resources LIC 402 Surety Bond (if applicable) LIC 610 Emergency Disaster Plan LIC 9020 Register of Facility Client’s/Resident’s Copy of Current Administrator's Certificate