Routine inspection·July 30, 2021

Licensing Program Analyst (LPA) Lydia Martinez conducted an unannounced visit for the purpose of conducting a Required 1 Year inspection. LPA was greeted and granted entry by Caregiver Rowena Daileg Assistant Administrator Cynthia Carsula was called and arrived shortly after. Reason for visit was explained. Upon entry LPA was screened per COVID guidelines. LPA began the tour of the facility. The facility currently has 5 residents in care of which 1 is a Respite resident. LPA observed residents to be clean and well cared for. Facility appears clean and sanitary. Facility staff screens all visitors to the facility and LPA observed the screening station on side kitchen counter. Facility keeps documentation in regard to COVID for all the visitors, staff, and resident. LPA observed hand washing guidelines posted in all bathrooms of facility. LPA observed facility has COVID precautionary posting throughout the facility as well as all required Department postings. Facility has an active COVID-19 prevention plan in place for the safety of residents in care. LPA observed ample of emergency food and water as well as First Aid kit in the facility. Facility has an ample supply of PPE, incontinence, and cleaning supplies. Facility has sanitation precaution in place. LPA toured the outside and observed a shaded outside space with furniture for residents to sit and can be used for outdoor visitation. Facility has a plan for COVID testing residents and staff as needed as well as a plan for isolation as needed. Mitigation Plan was submitted and has been approved. Based on the observations made during today’s visit, no deficiencies were noted per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with facility staff and a copy of this report was provided and left at facility.