Routine inspection·June 24, 2022

Licensing Program Analyst (LPA) Claudia Gutierrez made an unannounced visit for the purpose of conducting a Required/Annual Inspection. LPA was greeted by staff Anacito DiWayan and granted entry into the facility. LPA Gutierrez discussed the purpose of the inspection with staff DiWayan and staff Charlita Ariola. During the inspection LPA Gutierrez and staff Ariola conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, and observed the following: This is a single-story house with five bedrooms, and two bathrooms, with one bedroom being occupied by staff. Residents were observed having lunch in the dining area. Upon record review LPA noted emergency care requirements were met. LPA observed the facility does not have a 30-day supply of PPE on hand; a Technical Advisory was given on this date. LPA observed hallways and walkways were free of obstruction. LPA reviewed and confirmed facility policies and practices regarding resident screening; a Technical Advisory was given on this date, staff screening, visitation, COVID-19 surveillance testing, quarantine, isolation, cohorting, infection control training; a Technical Advisory was given on this date, PPE, staffing and staffing shortages. Based on the observations made during today’s inspection, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report was left at the facility.