Routine inspection·December 15, 2022

Licensing Program Analyst (LPA) Erik Gonzalez Campos arrived unannounced to conduct a Required - 1 Year inspection. This inspection was focused on the infection control practices and procedures of this facility. LPA met with administrator, Rolando Macaraig. LPA observed necessary COVID postings and screening materials at the front entrance. Screening procedure is required for all staff and visitors. LPA toured building and grounds which were clean and in good repair. Exits and walkways were clear from obstructions. LPA observed sufficient perishable and non perishable food. Toxins were locked and secured. Medications were locked and secured. Fire extinguishers inspected were last charged on 11/15/2022. Administrator confirmed facility has necessary PPE to support a resident in isolation. Local Public Health has provided staff with PPE and infection control training. LPA and administrator discussed training requirements for staff and resident record keeping. LPA and administrator discussed required documentation for hospice equipment like bed rails. LPA is requesting the following documents be submitted to Community Care Licensing within 30 days of today's inspection: LIC 308 Designation of Administrative Responsibility LIC 610 Emergency Disaster Plan LIC 500 Personnel Report LIC 9020 Resident Roster Evidence of Liability Insurance Admin Certificate Exit interview conducted with administrator. Report was emailed to administrator. No deficiencies observed during today's inspection.