Routine inspection·February 28, 2022

Licensing Program Analyst (LPA) Albert Marin made an unannounced required annual inspection in this facility. LPA met with Administrator (AD) Daniel Datcu and stated the purpose of this visit. The facility is a two level structure and licensed for six non-ambulatory of which one may be bedridden; and hospice waiver for three. For this visit, there was one resident under hospice care. About 12:35 PM , LPA Marin was granted entry after completing the Coronavirus 2019 (COVID 19) screening procedure. For this visit, there were six residents in care and two staff members on the floor. LPA toured the interior and exterior portions of the facility. There were six private resident's rooms. Rooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke carbon monoxide, and auditory exit alarms were tested to be operational. Paging system was in place and observed to be operational. Bathrooms were observed to be in good repair; and provided with handrails and nonskid-floor mat. Hot water was measured at 120 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food stock requirements. Medications, cleaning supplies and sharp items were inaccessible to residents in care. Fire extinguisher was mounted and charged. LPA observed personal protective equipment in place. For the exterior portion, facility had outside furniture in good repair. Grounds were free of tripping hazards. Side exit doors were self closing and self latching. LPA Marin reviewed the COVID 19 mitigation plan of the facility. LPA MArin advised to send all incident reports and general correspondence to CCLASCPOrangeCountyRO@dss.ca.gov No citation was issued during this visit. LPA Marin conducted an exit interview with AD Daniel Datcu and copy of this report was left in the facility.