Routine inspection·August 23, 2022

On 08/23/2022 at 3:30pm, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility in order to conduct a required annual inspection focusing mostly on Infection Control procedures. LPA was greeted and granted entry by caregivers. Licensee Maria Lat was notified by telephone and arrived shortly afterwards to assist with the visit along with administrator Priscilla Sanchez. At approximately 4:00pm, LPA accompanied by livensee toured the physical plant of the facility. There are currently four (4) residents in care including one (1) resident receiving hospice care. The residents are observed relaxing in their respective bedrooms and appear clean and well taken care of. The five (5) bedrooms include all necessary components. An ample supply of linen is observed. The two (2) bathrooms are equipped with grab bars and slip mats along with hand washing signs. Facility is clean, sanitary and free of odors in all areas inspected. Sharp instruments are stored in a kitchen drawer secured by a key lock. The centrally stored medication and resident files are located in a secure cabinet with functional magnetic locks near the kitchen. Cleaning supplies are located in multiple locations (sink cabinets, kitchen cabinet, attached garage), all of which are secure. LPA observed a sufficient supply of food and water present along with emergency water clearly marked in the garage. LPA observed the facility has COVID-19 Precautions posters and all required department postings. The Administrator Certificate posted is however expired since 07/05/2021. Licensee was able to provide LPA with a current certificate during the visit. A Technical Advisory is issued regarding the requirement for an up-to-date certificate on the facility's premises. Staff present is adequately cleared in Guardian with the exception of caregiver S1 who is currently shadowing. A deficiency is being cited for lack of background clearance along with the assessment of an immediate civil penalty. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 LPA and licensee toured the outside of the facility and observed it to be free of obstructions. Outdoor furniture and a shaded area are present for the enjoyment of residents and visitors. The perimeter gates are self-latching and can easily be opened in an evacuation. There are no bodies of water on the premises. A storage shed and a locked room dedicated to staff on their day off are also present in the backyard. Based on the observations made during today’s visit, one deficiency is being cited per Title 22 Division 6 of the California Code of Regulations and a immediate civil penalty is assessed. One (1) Technical Advisory notice is issued regarding the requirement for an up-to-date administrator certificate. This report was reviewed with facility representative and a copy of this report along with appeal rights was provided and left at facility.