Routine inspection·April 24, 2023

Licensing Program Analyst (LPA) Victoria Bertozzi arrived unannounced to conduct an Annual Required inspection and was greeted by staff. Administrator, Madonna Grace Martinez arrived later. Upon arrival, LPA observed that there was a screening station located outside along with Covid-19 signage and a poster advising individuals to wear masks. Staff was not wearing a mask. LPA spoke with Administrator who stated that masks were no longer required but they continued to screen visitors to encourage them not to visit the facility if they are not feeling well. LPA directed Administrator to update their Infection Control Plan to reflect facility policy on masking and screening. LPA initiated a tour of the facility around 10:20am and made the following observations: Facility was a comfortable temperature and passageways were free from obstructions. Resident rooms were furnished per regulation. Per staff, the water heater stopped working today and the Administrator is working on having a vendor come out to repair or replace the water heater. Staff provided the proof of service from the utility company indicating the need for repair. Facility has a plan to disinfect dishes and care for residents until water heater is repaired or replaced. Extra hygiene products and linens were available. Cabinet in kitchen containing cleaning supplies and cabinet containing knives was locked with a baby lock. LPA discussed the limitations of a baby lock in order to keep dangerous items inaccessible and discussed other options with Administrator. LPA observed a can of disinfectant in the bathroom cabinet that was not locked allowing access to residents in care. Staff immediately locked cleaner. Facility has at least two days of perishable and one week of non-perishable foods which appeared to be of quality and stored per regulation. Medications were centrally stored and locked. Fire extinguisher was last inspected February 2023. Smoke and Carbon Monoxide detectors located throughout the facility were tested and operational. Most recent fire/disaster drill was conducted January, 2023. Continued on LIC809C Continued from LIC809 Four staff files and five resident files were reviewed. Administrator Certificate for Administrator, Madonna Grace Martinez 6053462740 expires 6/20/2023. Medications and medication records were reviewed. Licensee/Administrator to submit updates of the following documents by 5/24/2023: Proof of Liability Insurance LIC308 Designation of Facility Responsibility (if applicable) LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan (If changes) Infection Control Plan (If changes) Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties.