Routine inspection·October 26, 2021

Licensing Program Analyst (LPA) Albert Marin made an unannounced required annual inspection in this facility. LPA met with Administrator (AD) Diana Manzano and stated the purpose of the visit. AD Angelica Reyes arrived in the facility shortly after. The facility is a two level structure and licensed for four non-ambulatory and with hospice waiver for four. For this visit, all residents were under hospice care. About 1:00 PM, LPA Marin was granted entry after completing the Coronavirus 2019 (COVID 19) screening procedure. For this visit, there were four residents in care and two staff members on the floor. LPA toured the interior and exterior portions of the facility. There were two shared resident’s rooms. Rooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke, carbon monoxide and auditory exit alarms and signal system were tested to be operational. Bathroom was observed to be in good repair; and provided with handrails and nonskid floor mat. Hot water was measured at 110 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. Pool feature was enclosed by a steel fence and inaccessible to residents in care. Side exit door was 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 ADs Angelica Reyes and Diana Manzano; and copy of this report was left in the facility.