Routine inspection·August 19, 2021

Licensing Program Analyst (LPA) Ruth Martinez conducted an unannounced visit for the purpose of conducting a required annual visit. LPA arrived at the facility was greeted and granted entry into the facility by Administrator Rebekah Buboi. LPA met with Administrator and explained the nature of the visit. LPA Martinez toured the facility. There are five residents in care and no active covid-19 cases. LPA observed two residents in the living room. Residents appeared clean and well taken care of. LPA observed required department postings in the facility as well as hand washing signs in the restrooms. All restrooms observed had soap/sanitized and appeared clean. Residents bedrooms appeared clean and sanitary with all required components. Facility is taking covid-19 precautionary measures daily. LPA observed a check in station with logs per covid guidelines. LPA observed the emergency disaster and evacuation plan posted. Facility has back-up emergency food and water supply as well as PPE supplies. Facility has completed the LIC808 Mitigation Plan and LPA Martinez approved the plan on site. Based on the observations made during today’s visit, no deficiencies were noted today per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, this report was reviewed with Administrator and a copy of this report was provided and left at facility.