Routine inspection·January 6, 2022

Licensing Program Analyst (LPA) Lopez arrived unannounced to conduct an Required- 1 year annual inspection and met with Administrator, Angelina Simi. The annual inspection was focused on the Infection Control procedures and practices. LPA conducted risk assessment with Administrator. LPA conducted a walk-through of the facility with Administrator. Fire Extinguishers were found to be last charged on July 19, 2021. There was sufficient amount of supply for both perishable and nonperishable foods. Facility smoke detectors and carbon monoxide were found to be functioning properly at the time of the visit. LPA observed COVID-19 precaution postings. LPA advised facility to take temperature for all staff, visitors and residents coming in to facility. Facility had sign-in sheet with screening questions at facility entrance. Resident's temperatures are taken twice a day and documented. Staff clean and disinfect the facility multiple times daily. Staff have completed training on PPE use but will have staff train on infection prevention, symptoms, transmission. The facility has a supply of PPE including gloves, face shields/goggles, N-95 respirators, surgical masks and disposable gowns. The facility has submitted a COVID-19 Mitigation Plan Report on Epidemic Outbreaks specific to COVID-19 which was reviewed by the California Department of Social Services. Exit interview conducted with Administrator, Angelina Simi whose signature on this document confirms receipt. No deficiencies cited during this inspection.