Routine inspection·August 24, 2021

Licensing Program Analyst (LPA) Ruth Martinez conducted an unannounced visit for the purpose of conducting a required annual visit. LPA arrived at the facility was greeted and granted entry by caregiver. LPA met with Juhayna Diaz, Administrator and explained the the nature of the visit. LPA accompanied by caregiver toured the facility. There are four residents in care and no active covid-19 cases in the facility. LPA observed one resident in living room and two residents in their bedrooms. All residents appeared clean and well taken care of. LPA observed required department posting and covid precautionary postings in the facility. All restrooms observed to have soap/sanitizer and appeared to be clean. Residents bedrooms are currently all private and appeared to be clean and sanitary with all required components. Facility is taking covid-19 precautionary measures daily. LPA observed a check in station with sanitary precaution on the main entry of the facility. LPA observed the emergency disaster and evaluation plan. LPA observed food, water as well as first aid kits in the facility. LPA observed two shaded seating areas in the backyard for residents enjoyment, area is used for outdoor visitation as well. Facility has a supply of PPE, incontinence, and cleaning supplies. Facility has completed the LIC808 Mitigation Plan and LPA Martinez reviewed/approved the plan on site. Based on the observation made during today's visit, no deficiencies were noted today per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, this report was reviewed with Administrator and a copy of this report was provided and left at facility.