Routine inspection·December 6, 2021

Licensing Program Analyst (LPA) Albert Marin made an unannounced visit to conduct the required annual inspection in this facility. LPA met with Administrator (AD) Richard Mendoza Sr. and stated the purpose of this visit. The facility is a single structure and licensed for six non-ambulatory and with hospice waiver for six. For this visit, there was one resident under hospice care. About 2:35 PM, LPA Marin was granted entry after completing the Coronavirus 2019 (COVID 19) screening procedure. Facility had four residents in care and two staff members on the floor. LPA toured the interior and exterior portions of the facility. There were two shared and two private rooms. Rooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Hardwired smoke, carbon monoxide and auditory exit alarms were tested to be operational. Bathrooms were observed to be in good repair, provided with grab bars and nonskid floor mats. Hot water was measured at 116 degrees Fahrenheit. Facility met the minimum two day perishable and seven day non-perishable food stock requirements. Medications, cleaning supplies and sharp items were inaccessible to residents in care. Fire extinguisher was mounted and charged. For the exterior portion, facility had patio furniture in good repair, and grounds were free of tripping hazards. Side exit doors were self-closing and self-latching. Pool feature of the facility has an enclosed steel fence and rendered inaccessible to residents in care. LPA Marin reviewed the COVID 19 mitigation plan of the facility For this visit, the facility was observed to be in substantial compliance with Title 22 Division 6 of the California Code of Regulations. LPA Marin conducted an exit interview with Administrator Mendoza; and copy of this report was left in the facility.