Routine inspection·June 27, 2022

Licensing Program Analyst (LPA) Andrea Mendivil conducted an unannounced visit for the purpose of conducting a required annual visit. LPA was greeted and granted entry into facility by Caregiver Gina Servino and explained the reason for the visit. Administrator Arlene Fajardo arrived at 2:10 PM At 2:10 PM, LPA toured facility with Administrator Arlene Fajardo. Facility has 5 residents present during today’s visit. Facility is a 7 bedroom, 3 bathroom, two story home with an attached garage. LPA observed a screening and sanitizing station at entrance of the facility. LPA observed residents relaxing in the facility or in their respective rooms. Facility appears clean and sanitary. All resident rooms had required elements, including bed, chair, closet space and ample lighting. Restrooms are stocked with soap and paper towels. Facility has 2 refrigerators with ample food supply. LPA observed facility has emergency food and water supply. Facility has a secured location for resident medication and files. LPA toured the outside grounds and observed outside visitation areas. Facility has a plan for covid testing residents and staff as needed as well as a plan for isolation. LPA reviewed all residents’ files and all contained required documentation including updated emergency information. All staff and residents are fully vaccinated for Covid 19. 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.