Routine inspection·August 4, 2022

Licensing Program Analyst (LPA) Celine De Perio conducted an unannounced required annual inspection focusing primarily on the Infection Control. LPA De Perio was greeted and granted entry by staff on duty who checked temperature prior to entering facility. During the visit, 2 staff were on duty, who contacted facility administrator (AD) Carmen Rivas about visit. AD Rivas provided consent for staff on duty (S1) Elizabeth Ferrer to conduct tour, sign and receive report, due to AD Rivas being unavailable and having to attend a medical appointment. As of 8/2/22, there are no active COVID-19 cases in the facility as verified. LPA De Perio observed the COVID-19 precautionary signs posted in the hallway of the facility. The PUB475 "See Something, Say Something" poster was also observed to be located in the hallway. LPA De Perio toured the interior and exterior portions of the facility with S1. The facility is a single level structure and is licensed for 6 non-ambulatory residents, 0 bedridden and 2 hospice . Currently, there are a total of 4 residents in care, of which 1 is on hospice. All bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. The restrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature in restrooms were measured at 106.4 degrees Fahrenheit and hand washing signs were also posted in each restroom. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to residents in care. Fire extinguisher was charged, mounted and located in the kitchen. For the exterior portion, LPA De Perio observed patio furniture under shading, and the grounds were free of any hazards. There are 2 gates in the backyard, which both were self-closing and self-latching. LPA De Perio observed the emergency disaster and evacuation plan, which is posted in the hallway of the facility. Facility had back-up emergency food and water supply, located in the garage. LPA De Perio observed that First Aid Kit had all the required components. The facility had an adequate supply of PPE that was located in the living room. Medications were locked and located in a kitchen cabinet. Toxins were also observed to be locked and inaccessible to residents. LPA De Perio verified the Coronavirus 2019 (COVID 19) mitigation plan of the facility with S1. LPA De Perio discussed Assembly Bill 665 requires that a licensee of any adult or senior care residential facility that has internet service provide at least one internet access device, such as a computer, smart phone, tablet or other device, that: can support real-time interactive applications; is equipped with video conferencing technology, including microphone and camera functions; and is dedicated for client or resident use. For today's visit no deficiencies were issued per Title 22 Division 6 of the California Code of Regulations. LPA De Perio advised S1 and AD Rivas to use the general email address: CCLASCPOrangeCountyRO@dss.ca.gov for any inquiries and to specify attention to the assigned LPA. LPA De Perio conducted an exit interview with S1 and AD Rivas via phone call and a copy of this report was provided to the facility.