Routine inspection·August 24, 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 Dolores Martillano and explained the reason for the visit. Administrator Rico Almiranez arrived during the visit. At 1:20 PM, LPA toured the facility with Administrator Almiranez. Facility has 6 residents in care during today's visit. LPA observed residents relaxing in the facility. All resident rooms had the required elements as well as restrooms stocked with soap/ sanitizer as well as hand washing signage. All rooms are single occupancy. Facility screens all visitors to the facility and LPA observed the screening/ sanitizing station in the facility. Facility utilizes a visitor sign in sheet. Facility takes resident temperatures daily and documents results. LPA observed ample sanitizer spread out throughout the facility. Facility has covid precaution postings as well as all required department postings. Facility mitigation plan has been submitted and approved. LPA observed an ample supply of emergency food and water in the garage. LPA toured the outside grounds and observed the shaded outside visitation area. Exit gate is unlocked. At 1:30 PM, LPA observed the medication storage area was unsecured. Facility has a plan for covid testing residents and staff as needed as well as a plan for isolation and quarantine. LPA reviewed six resident files during the visit and all contained updated emergency information. LPA observed three out of six residents are under the age of sixty. Residents 1, 3, and 4 are under the age of sixty thus outside of the conditions of the license. One out of six residents has bedridden status in the file. All residents and staff are vaccinated for Covid-19. LPA consulted with Administrator regarding the importance of following department recommended guidelines for covid precautions and visitation for residents. Based on observations made during today's visit, the following deficiencies were cited based on Title 22, Division 6, of the California Code of Regulations. An exit interview to review this report was conducted and a copy along with Appeal Rights, LIC 811- Confidential Names list, LIC 421C- Civil Penalty Assessment, and LIC 9102TA- Advisory Notes was provided.