Routine inspection·February 14, 2022

Licensing Program Analyst (LPA) Albert Marin made an unannounced required annual inspection in this facility. LPA met with House Supervisor (HS) J. Gonzalez and stated the purpose of this visit. Via phone, HS informed Administrator (AD) Shimon Cagan about the presence of LPA in the facility. The facility is a single level structure and licensed for six non-ambulatory and with hospice waiver for three. For this visit there were two residents under hospice care. About 11:43 AM, LPA Marin was granted entry after completing the Coronavirus 2019 (COVID 19) screening procedure. For this visit, there were five residents in care and two staff members on the floor. LPA toured the interior and exterior portions of the facility. There were four private and one shared resident’s 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; and provided with handrails and nonskid - floor mats. Hot water was measured at 105 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-latching and self-closing. 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 HS Gonzalez; and copy of this report was left in the facility.