Routine inspection·August 12, 2022

Licensing Program Analyst (LPA) Jerome Haley conducted an unannounced visit for the purpose of conducting a required one year infection control annual visit. LPA was greeted, granted entry by staff, and explained the reason for the visit. Facility staff called Administrator (AD) Catherine Mendoza who was unavailable. Staff then called Justine Mendoza who arrived at the end of the inspection. AD Mendoza has a current administrators certificate that expires 4/21/24. At 11:40 AM LPA Haley began the inspection with staff. There were four residents present during todays visit. A screening station was observed near the front door. LPA Haley was temperature checked before entering the facility. Right next to the front door there's a half bathroom for visitors. Next to the bathroom by the front door there's a closet with a supply of non perishable items. All required postings were observed on the walls through out the facility. Resident rooms and bathrooms were equipped with all the necessary requirements. Hot water temperatures measured at 106.1 degrees Fahrenheit in bathroom #1 and 105.9 degrees Fahrenheit in bathroom #2. Plenty of extra linen was observed in the hallway closet. There's an office in between the dining room and living room. In the office LPA Haley observed a closet with a adequate supply of PPE and a first aid kit. The garage is used as a storage space. LPA observed mattresses, bed frames, wheelchairs, and walkers. A walk way clear and clutter and tripping hazards was observed. In the garage LPA Haley observed a cabinet with cleaning supplies, a washer and dryer, and a refrigerator with some perishable food items present. An emergency supply of water was observed in the garage. The back yard was clean and free of clutter and debris. A shaded area with tables and chairs was observed. The side exit gate was self closing and self latching. Continued on LIC 809 C Dated 8/12/22 In the kitchen knives and sharp objects are stored under the kitchen sink. All four burners on the stove were operational. LPA observed a 2 day supply of perishable items and a 7 day supply of non perishable items. There was a charged and mounted fire extinguisher observed in the kitchen. Smoke detectors battery powered and individually operating. Seven smoke detectors were operational. In the hallway one smoke detector was tested and observed to be non operational. No bodies of water were observed during today's visit. Deficiencies are being cited per California Code of Regulations Title 22 Division 6 Chapter 8, and a technical advisory will be issued during todays visit. An exit interview was conducted and a copy of the report and appeal rights were left at the facility.