Routine inspection·October 18, 2021

Licensing Program Analyst (LPA) Ruth Martinez conducted an unannounced visit for the purpose of conducting a required annual inspection. LPA was greeted and granted entry into the facility by caregiver. LPA met with Rico Mico, Administrator and explained the nature of the visit. LPA Martinez began the tour of the inside and outside of the facility. There are six residents in care and there are no active covid-19 cases in the facility. LPA observed three resident watching television and the remainder of resident in their bedrooms. All residents appeared to be clean and well taken care of. LPA observed required department postings and hand washing postings in bathrooms were noted. All restrooms observed to have ample supply of soap and appeared to be clean. LPA inspected residents’ bedrooms, and all appeared to be clean and sanitary. All bedrooms observed to have all required components. LPA observed a check in station in the main entry of the facility. Facility is taking temperatures daily and documenting the results. LPA observed the emergency disaster and evacuation plan. Facility has supply of emergency food and water as well as PPE supplies in the attached garage. The second floor of the facility can be assessed through the attached garage, resident in care do not have access to second floor. There are no residents residing in the second floor of the facility. LPA toured the outside of the facility and observed a shaded seating are for the resident’s enjoyment. The facility has completed the LIC808 Mitigation Plan, LPA reviewed and approved the plan on today’s visit. LPA emailed the signed and approved plan to the Administrator for their records. Based on the observation made during today’s visit, no deficiencies were noted today per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with the Administrator and a copy of this report was provided to the facility.