Routine inspection·June 28, 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 by Licensee/ Administrator Esther Rey and explained the reason for the visit. Administrator Rey has a current administrator certificate expiring on 02/27/2024. At 11:31 AM, LPA toured the facility with Administrator Rey. Facility has 5 residents in care during today's visit with two on hospice. LPA observed residents relaxing in the facility. All residents appeared happy and well taken care of. Facility appears clean and sanitary. At 11:35 AM, LPA toured the unlocked garage and observed unsecured cleaners and laundry supplies. LPA observed unsecured cleaning supplies in the adjacent restroom. All resident rooms had the required elements as well as restrooms stocked with soap/ sanitizer. Rooms are single and double occupancy. LPA observed the screening/ sanitizing station in the entrance of the facility. Facility utilizes a visitor sign in sheet. Facility takes resident and staff temperatures daily. LPA observed the first aid kit has all required items. At 11:45 AM, LPA observed the medication closet is unlocked and medications are accessible to residents in care. There are unsecured vitamins and cleaning supplies/ disinfectants in the kitchen as well as unsecured medication in the refrigerator. Sharps are unlocked under the kitchen counter. LPA observed an ample supply of emergency food and water as well as PPE. Smoke detectors tested operational during today's visit. LPA toured the outside grounds and observed the shaded outside visitation area. Facility has unsecured toxins in the outside visitation area as well as unsecured sharps. Exit gate is unlocked and self latching. Residents participate in activities such as puzzles, exercise, and drives in the community. LPA reviewed all resident files and three out of five residents with Dementia have outdated physician reports. Facility has a plan for covid testing residents and staff as needed as well as a plan for isolation and quarantine. All residents and staff are vaccinated for Covid-19. LPA consulted with Administrator regarding the importance of hand washing signs in all facility restrooms as well as ensuring the emergency disaster plan is posted in the facility. Additionally, LPA consulted with Administrator regarding visitation guidelines. CONTINUED ON LIC 809C DATED 06/28/2022. Based on the observations made during today's visit, Deficiencies are being cited under California Code of Regulations, Title 22, Division 6, Chapter 8. Exit interview conducted with Administrator Rey and a copy of this report along with the appeal rights and LIC 811 were provided at the time of this visit.