Routine inspection·September 26, 2022

On 09/19/2022 at 11:15pm, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility in order to conduct a required annual inspection focusing on Infection Control procedures. LPA was greeted and granted entry by caregiver Miriam Blanca and explained the purpose of the visit. Administrator Miguelito Fajardo was notified by phone and arrived later to assist with the visit. At approximately 12:10pm, LPA accompanied by administrator toured the physical plant of the facility. There are currently five (5) residents in care, one (1) of which is receiving hospice care. Residents are observed relaxing in the facility's common areas or in their respective bedrooms. All appear clean and well taken care of. The four individual and one shared bedrooms include all necessary components. Bathrooms are equipped with grab bars and slip mats. Facility is clean, sanitary and free of odors in all areas inspected. Sharp instruments are kept in a locked drawer in the kitchen. Cleaning supplies are located in a cabinet under the sink with a child-proof lock and in other cupboards in the locked laundry area. The centrally stored medication is located in a locked closet next to the entrance door. LPA observed a sufficient supply of food and water present. Emergency water and rations are also stored in the attached garage. The facility has an ample supply of linen available for use by residents. LPA observed the facility has COVID-19 Precautions posters and all required department postings along with hand washing signs. The fire extinguishers present are charged and have up-to-date maintenance shown on the attached tag.The regular caregivers S1 and S2 called out due to a family emergency. Administrator had to make last minute adjustments and hire relieving caregivers on short notice. One of the two caregivers (S3) present is adequately cleared in Guardian but is not associated to the facility. Another caregiver present (S4) is not currently background checked in the state of California and has only previously worked in Arizona. Caregiver is not associated to the facility either. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 LPA and administrator toured the outside of the facility and observed it to be free of obstructions. Outdoor furniture and an umbrella for shade are present in the backyard for the enjoyment of residents and visitors. The perimeter gates on both sides of the facility are self-latching and can easily be opened in an evacuation. There are no bodies of water on the premises. Based on the observations made during today’s visit, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. A Technical Advisory regarding staff associations is being issued. This report was reviewed with facility representative and a copy of this report was provided and left at facility.