Routine inspection·October 28, 2021

Licensing Program Analyst (LPA) Ruth Martinez conducted an unannounced visit for the purpose of conducting a required annual inspection. LPA was greeted and granted entry into the facility by caregiver. Administrator arrived shortly after and met with LPA. LPA accompanied by caregiver began the tour of the inside and outside of the facility. There are six residents in care and there are no active covid-19 cases in the facility. LPA observed a check in station in the outside entry of the facility which follows covid guidelines. Facility is taking temperatures daily and documenting the results. LPA observed two residents in the living room watching TV and the remainder of residents in their bedrooms. All residents appeared clean and well taken care of. LPA observed required department posting and covid-19 precautionary postings in the facility. LPA inspected bathrooms and observed to have ample supply of soap and they appeared to be clean. LPA inspected residents’ bedrooms and they appeared to be clean and sanitary. All bedrooms were observed to have all the required components. The facility has four private bedrooms with one resident per and one bedroom is shared with two residents. LPA observed the emergency disaster and evacuation plan posted. Facility has back-up emergency food and ample supply of PPE. LPA toured the outside of the facility and observed several shades seating areas for resident’s enjoyment. LPA observed there is a swimming pool that meets Title 22 regulations at this time. The facility has completed the LIC808 Mitigation Plan, LPA reviewed and approved the plan on today’s visit. LPA emailed the signed and approved plan to the Administrator for their records. Based on the observation made during today’s visit, no deficiencies were noted today per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with the Administrator and a copy of this report was provided to the facility.