Routine inspection·May 27, 2021

Licensing Program Analyst (LPA) Jim August conducted an unannounced visit for the purpose of conducting a required annual visit. LPA was greeted and granted entry into the facility by Caregiver Melanie Moreno and explained the reason for the visit. Administrator Mark Cruz arrived shortly after. At 8:35 AM, LPA August toured the facility with Melanie Moreno. There are five residents residing in the facility and no active covid-19 cases. LPA observed all five residents on site. All residents appeared clean and well taken care of. LPA observed required department postings in the facility as well as hand washing signs in the restrooms. All restrooms observed had ample soap/sanitizer and appeared clean. Resident bedrooms appeared clean and sanitary and had all required components. Facility is taking client's temperatures daily and documenting results. LPA observed the emergency disaster and evacuation plans. Facility has back-up emergency food and water supply. LPA observed the PPE supply of surgical masks, gowns and gloves in the garage. LPA consulted with Administrator Cruz regarding community cloth towels in restrooms and ensuring the paper towels are always stocked. Facility has LIC808 Mitigation Plan awaiting approval. No citations noted during today's visit. Exit interview conducted and a copy of this report was left at the facility.