Routine inspection (multi-day)·April 17, 2024

At approximately 10:30AM, Licensing Program Analyst (LPA) Felias arrived unannounced to continue a Required 1 Year visit and met with Administrator, Rufus Zingkhai, and Designated Representative Giov Alipio. Upon arrival, LPA was informed that there were 33 residents in care and 6 staff members on-site. At approximately 10:40AM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. LPA conducted a walk-through of facility and observed the following: There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Facility's fire and sprinkler system was last inspected March 2024. LPA reviewed staff and resident files and resident medication. Resident files were all found to be well organized, thorough and contained the required documentation. Staff files had current First Aid and CPR certification. During staff file review, LPA observed that two staff members did not have a health screening form in their file but did have proof of negative TB test (See technical violation, LIC9102, Regulation 87411(f)). Medication was observed to be centrally stored and secure. Administrator's Certificate for Rufus Zingkhai (6053315740) was current with an expiration date of 08/15/2025. Facility has an Infection Control plan on file. LPA requested the following documents to update facility file: Designation of Facility Responsibility (LIC 308) Emergency Disaster Plan (LIC 610D) Updated Personnel Report (LIC 500) Register of Clients/Residents (LIC 9020) Updated Liability Insurance Documents to be submitted to Community Care Licensing (CCL) by due date of 05/17/2024. No Deficiencies Cited during visit. Exit interview conducted. Copy of report, LIC9102 (Technical Advisory/Violation) discussed and provided to Administrator. Signature on form confirms receipt of documents.