Routine inspection·May 20, 2021

Licensing Program Analyst (LPA) Albert Marin conducted an unannounced required annual inspection to this facility. LPA met with Administrator Heidi Baha and stated the purpose of this visit. LPA was granted entry after completing the Coronavirus 2019 (COVID 19) screening procedure of the facility. The facility is a single level structure and licensed for capacity of six non-ambulatory; and has an approved hospice waiver for three. For this visit there was one resident under hospice care. About 11:15 AM, LPA toured the interior and exterior portions of the facility with AD Baha There were one shared and four private resident's rooms; and one staff room. Resident's rooms were provided with adequate furniture, clean linens, adequate storage space, and kept free of tripping hazards. Smoke, carbon monoxide and auditory exit alarms were observed to be operational. Bathrooms were provided with grab bars, non-skid floor mats, and 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. Patio furniture was observed in good repair. Exterior exit doors were self-closing and self-latching. LPA provided consultation on best practices in facility documentation. 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 AD Baha and copy of this report was left in the facility.