Routine inspection·May 25, 2021

This unannounced inspection is being conducted by Licensing Program Analysts (LPAs) Sean Haddad and Norman C. Woodridge for the purpose of conducting an Annual Inspection. LPAs met with Administrator (AD) Vijay Kanase and discussed the purpose of the inspection. During the inspection, LPAs and AD conducted a tour of the inside of the facility, common areas, resident rooms, and kitchen and observed the following: LPAs and AD observed there was 1 staff present, wearing PPE. LPAs observed 3 residents were present. LPAs confirmed all residents were doing well. LPAs inspected common areas, resident rooms, garage, and kitchen, and observed they were clean and organized. LPAs observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food is available as required by regulations. LPAs observed hallways and walkways were free of obstruction. At 9:35 AM, in the attached non-lockable garage, LPAs and AD observed toxins accessible to residents, including laundry detergent, cleaning supplies, and pesticides, with the laundry detergent stored next to food. In the kitchen, LPAs and AD observed knives accessible to residents on the kitchen counter, lockable medication cabinets accessible to residents with the keys left in the locks, keys for other lockable compartments containing dangerous items accessible to residents, and screwdrivers and superglue accessible to residents. During the inspection, AD moved all toxins from the garage to the locked laundry room, moved knives to a locked drawer, removed keys and made them inaccessible, and secured other dangerous items such as screwdrivers and superglue. (Page 1) LPAs reviewed and confirmed facility policies and practices regarding resident screening, staff screening, visitation, COVID-19 surveillance testing, COVID-19 clearance testing, quarantine, isolation, cohorting, staffing, infection control/lead/training, PPE, staffing and staffing shortages, communication and emergency plan, and dementia. LPAs provided technical assistance regarding visitation, COVID-19 signs, resident outings, COVID-19 testing, staff health screenings, and N95 fit testing. LPAs requested and reviewed resident roster, staff roster, staff files, emergency plan, and COVID-19 mitigation plan. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 of the California Code of Regulations. See LIC809D. An exit interview was conducted and a copy of this report as well as appeal rights was discussed with and provided to facility representative. (Page 2)