Routine inspection·September 15, 2022

Licensing Program Analysts (LPAs) Kimberly Lyman and Alvaro Ramirez conducted an unannounced visit for the purpose of conducting a required annual visit. LPAs were greeted and granted entry into the facility by Administrator Nargis Elahi and explained the reason for the visit. Administrator Nargis Elahi has an administrator certificate expiring on 11/11/2022. At 9:55 AM, LPAs toured the facility with Administrator Elahi. Facility has five residents in care during today's visit with two on hospice. LPAs observed residents relaxing in the facility. All residents appeared well taken care of. Facility appears clean and sanitary. All resident rooms had the required elements as well as restrooms stocked with soap/ sanitizer. Rooms are single occupancy with Administrator living quarters on the second floor of the facility. LPAs observed the screening/ sanitizing station in the entrance of the facility. Facility utilizes a visitor sign in sheet. Facility is not taking/ documenting staff, resident, or visitor temperatures. Facility has covid precaution postings as well as all required department postings. LPAs observed the first aid kit has all required items. Mitigation plan and infection control plan has been submitted. LPAs observed an ample supply of emergency food and water. LPAs toured the outside grounds and observed the shaded outside visitation area. Exit gate is unlocked. LPAs observed the locked medication storage area. At 10:45 AM, LPAs observed unsecured cleaning supplies, knife, and scissors in an unsecured kitchen cupboard. Residents participate in activities such as games, puzzles and exercise. Facility has a plan for covid testing residents and staff as needed as well as a plan for isolation and quarantine. LPAs reviewed select resident files during the visit and all files have updated emergency information. All residents and staff are vaccinated for Covid-19. LPA consulted with Administrator regarding the importance of staff and visitors wearing masks inside the facility. Based on the observations made during today's visit, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with Administrator and a copy was provided as well as appeal rights