Routine inspection·March 3, 2022

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced visit for the purpose of conducting a required/ annual visit. LPA was greeted and granted entry into the facility and explained the reason for the visit. Administrator Mel Aguila arrived during the visit. Administrator Virgilo Aguila has an administrator certificate expiring on 02/14/2023. At 9:25 AM, LPA toured the facility with Caregiver Michelle Solomon. Administrator Mel Aguila joined the tour in progress. Facility has 5 residents in care during today's visit with 3 residents on hospice care. LPA observed residents relaxing in the facility. All residents appeared happy and well taken care of. Facility appears clean and sanitary. All resident rooms had the required elements. At 9:35 AM, LPA observed unsecured vitamins in the unlocked caregiver room. Facility screens all visitors to the facility and LPA observed the screening/ sanitizing station in the facility. Facility utilizes a hand written visitor sign in sheet/ questionnaire. Facility takes resident and staff temperatures daily. LPA observed the first aid kit has all required items. Facility mitigation plan has been approved. LPA observed an ample supply of emergency food. LPA observed the shaded outside visitation area. Exit gates are self latching and unlocked. LPA observed the locked medication area. Facility does not use a medication administration record. Facility does a monthly audit of medications. Facility provides activities in the form of exercise and games. Facility has a plan for covid testing residents and staff as needed as well as a plan for isolation and quarantine. LPA reviewed all resident files during the visit and all files have updated emergency information. All residents and all staff are vaccinated for Covid-19. LPA consulted with Administrator regarding the importance of maintaining an ample supply of emergency food and water on-site at the facility. The following deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. This report, along with appeal rights, were discussed with the facility representative and a copy of this report was provided to the facility at exit.