Routine inspection·November 3, 2022

Licensing Program Analyst (LPA) Edward Tapia made an unannounced required annual inspection at this facility. LPA met with Administrator Shimon Cagan and stated the purpose of this visit. The facility is a single-level structure and licensed for six non-ambulatory with a hospice waiver for six. This facility is a Residential Care Facility for the Elderly/Hospice. At about 11:13 am, LPA Tapia was granted entry after completing the Coronavirus 2019 (COVID 19) screening procedure. For this visit, LPA observed residents in care and staff members on duty. LPA toured the interior and exterior portions of the facility. There were 4 resident rooms 1 of which was shared room. Resident rooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Manual smoke detectors, carbon monoxide and auditory exit alarms were tested to be operational. Bathrooms were observed to be in good repair and provided with grab bars and hot water was measured at 111.7 degrees Fahrenheit. Facility met the minimum two-day supply of perishable and seven-day supply of non-perishable food stock requirements. Kitchen was in good repair with cleaning supplies and sharp items inaccessible to residents in care. Medications were kept locked separately. Facility had adequate supplies of personal protective equipment in place. Fire extinguisher was observed. Facility offers a 2-car garage that is kept locked and used for storage with emergency supplies, an extra freezer and refrigerators. Laundry room contained an operational washer and dryer with detergents kept locked. For the exterior portion, facility had outside furniture in good repair; and grounds were free of tripping hazards. Outdoor patio contained a water fountain and well maintained plants and a tree. LPA Tapia reviewed the COVID 19 mitigation plan and the Emergency disaster plan of the facility. LPA discussed Assembly Bill 665 that requires a licensee of any adult care residential facility that has internet service to 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 this visit, no deficiency was noted in areas observed. LPA Tapia conducted an exit interview with Administrator Shimon Cagan and copy of this report was explained and left at the facility.