Routine inspection·October 26, 2021

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 Caregiver Luzvimda Estrella and explained the reason for the visit. Administrator Ramil De Los Santos has an administrator certificate expiring on 09/27/2022. House Manager Christy Valerio arrived during the visit. At 11:30 AM, LPA toured the facility with Caregivers Luzvimda and Epi Estrella. Facility has 5 residents present during today's visit. LPA observed residents relaxing in the facility. All residents appeared happy and well taken care of. Facility appears clean and sanitary. All resident rooms are currently single occupancy and had the required elements as well as restrooms stocked with soap/ sanitizer. Facility screens all visitors to the facility and LPA observed the screening/ sanitizing station in the entrance of the facility. Facility utilizes a visitor sign in sheet and documents temperatures. Facility has covid precaution postings in facility but not at entrance to facility. First aid kit has all required items. Facility mitigation plan has been submitted and approved. LPA toured the outside grounds and observed multiple shaded outside visitation areas. Exit gates are unlocked and self latching. At 11:45 AM, LPA observed unsecured medication and vitamins in the unlocked caregiver room. LPA entered the unlocked garage and observed unsecured cleaning supplies such as laundry soap, raid, tile cleaner, and Ajax at 11:50 AM. LPA toured the kitchen and observed ample food supply. Residents participate in activities such as music, games, and exercise. Facility has ample supply of PPE and cleaning supplies. Facility has a plan for covid testing residents and staff as needed as well as a plan for isolation and quarantine. LPA reviewed all resident files during the visit and all files are up to date including emergency information and physician reports. All residents and staff are vaccinated for Covid-19. LPA consulted with House Manager regarding the importance of maintaining an ample supply of emergency food and water at all times. Based on the observations made during today's visit, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with the facility representative and a copy was provided as well as appeal rights.