Routine inspection·October 26, 2021

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced visit for the purpose of conducting a required/ annual visit. LPA was greeted and granted entry into the facility by Caregiver Willie Leonardo and explained the reason for the visit. Administrator Rose Palma has an administrator certificate expiring on 11/18/2022. Administrator Rose Palma arrived during the visit. At 9:12 AM, LPA toured the facility with Caregiver Leonardo. Facility has 5 residents present during today's visit. LPA observed residents relaxing in the facility. All residents appeared happy and well taken care of. Facility appears clean and sanitary. All resident rooms are currently single occupancy and had the required elements as well as restrooms stocked with soap/ sanitizer. Facility screens all visitors to the facility and LPA observed the screening/ sanitizing station in the entrance of the facility. Facility utilizes a visitor sign in sheet and documents temperatures and potential health symptoms. Facility has covid precaution postings as well as most required department postings. First aid kits have all required items. Facility mitigation plan has been submitted and approved. Auditory exit alarms in the master bedroom is inoperable and exit alarm in living room is turned off. Per physician reports, four out of five residents are diagnosed with Dementia with one resident having wandering tendencies. LPA toured the outside grounds and observed multiple shaded outside visitation areas as well as a fenced and secured pool. Exit gates are unlocked and self latching. At 9:25 AM, LPA observed unsecured medication and vitamins in the unlocked caregiver room. LPA toured the kitchen at 9:40 AM and observed unsecured cleaning supplies as well as unsecured scissors in the kitchen area. Facility has ample food supply. Residents participate in activities such as music and bingo. Facility has ample supply of PPE and cleaning supplies. Facility has a plan for covid testing residents and staff as needed as well as a plan for isolation and quarantine. LPA reviewed all resident files during the visit and all files are up to date including emergency information and physician reports. LPA consulted with Administrator Palma regarding the importance of maintaining an ample supply of N95 masks on-site at all times. Based on the observations made during today's visit, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with the facility representative and a copy was provided as well as appeal rights.