Routine inspection·May 24, 2021

Licensing Program Analyst(s) (LPAs) Sarangi and Fernandes-Goes conducted an unannounced Required – 1 year. Infection Control inspection to this facility and met with administrator Rufus Zingkhai. There was 36 residents present at the facility. LPAs arrived at the facility and had our temperatures checked and logged into a log. During facility tour on 5/24/2021 with administrator; 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 Extinguisher was found to be last charged on March 20, 2021 at the time of the visit. Facility smoke detectors are hard wired and sound directly to the fire station. There was a sufficient supply of both perishable and non-perishable foods as required by Title 22 Regulations. Food stored in the refrigerator were properly stored as per regulations on this day at the time of the visit. Toxins are stored in a locked closet in the hallway. Dangerous items were stored inaccessible to clients. There was a supply of cleaners, hygiene products and paper products available for clients. All resident’s bedrooms have lighting & appropriate furnishings. LPAs observed beds with pans down below filled with Vegetable Oil for bedbugs. LPAs observed bedbugs in the bowl. After review, it was disclosed in May 2020 facility had a complaint regarding bed bugs which was unsubstantiated due to facility having an exterminator coming to the facility. During this visit as per documentation on file provided by administrator Rufus Zingkhai, last exterminator visit occurred on 3/2020. Facility administrator also stated that there is an email showing as proof of last treatment occurring on 10/2020. Facility had no proof of service/receipt. (see pictures, LIC 809-D) Infection Control: Facility has submitted a mitigation program plan that was approved on March 01, 2021. Staff before coming into work have temperature checked. (Report continued on LIC 809C) Facility has PPE supply stored in the Administrator office at the facility. There has been 1 new staff hired since COVID-19. Residents’ medications are stored and locked in the hallway across the Administrator office. Facility has a 30-day supply of medication for clients. Residents are wearing masks inside the facility. All staff had masks on during this visit. In addition, facility has a designated area for visitors which are being allowed for scheduled visits. Staff have had all PPE training required on file and still working towards acquiring N-95 fit testing. In addition, LPAs advised facility to contact County Public Health and Community Care Licensing immediately if symptoms or COVID-19 + in the facility. Disaster Drills have been conducted quarterly with the last one on March 10, 2021. Deficiencies were observed on May 24, 2021 at 09:45 AM, and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given to the Administrator. A copy of this report was signed by the Administrator.