Routine inspection·May 2, 2022

Licensing Program Analyst (LPA) Lydia Martinez conducted an unannounced visit for the purpose of conducting a Required - 1 Year evaluation. LPA was greeted and granted entry into the facility by Staff Orlando DeLos Angeles. Licensee/Administrator Concordia Velasco arrived shortly after and explained the reason for the visit. Licensee/Administrator Velasco does not have an active certificate as it expired 2 or 3 years ago. LPA Martinez toured the facility with Staff DeLos Angeles. Facility has 4 residents in care during today's visit. LPA observed residents in their room taking their afternoon nap. All Residents appeared clean and well taken care of. Facility appears clean and sanitary. Resident rooms had the required elements. Facility does not screen visitors to the facility, but observed the screening/sanitizing station in the facility's entrance. Facility utilizes a hand written visitor sign in sheet. Facility does not monitor resident's and staff temperatures. LPA observed the First Aid kit has all required items. Smoke detectors tested operational during today's visit and Fire Extinguisher were fully charged. LPA observed sufficient supply of emergency food and water as well as emergency supplies. Food supply was sufficient. Toxins are secured. LPA observed a shaded outside visitation area. LPA observed the locked medication area. Facility utilizes a medication administration record. Facility provides activities in the form of exercise and games. Facility has a plan for COVID testing residents and staff as needed as well as a plan for isolation and quarantine. LPA reviewed all residents files during the visit and all files have updated emergency information as well as required documents. All resident and staff are vaccinated for COVID-19. LPA consulted with Licensee on the importance of COVID-19 postings throughout the facility as well as screening visitors, residents and staff and documenting. Based on the observations made during today’s visit the following deficiencies is being cited per Title 22 Division 6 of the California Code of Regulations. This report, along with Appeal Rights, was discussed with the Licensee Velasco and a copy of this report will be emailed on today's date.