Routine inspection·February 16, 2022

Licensing Program Analyst (LPA) Albert Marin made an unannounced required annual inspection in this facility. LPA met with Administrator (AD) Mark Mendez and stated the purpose of this visit. The facility is a single level structure and licensed for six non-ambulatory of which one may be bedridden; and with hospice waiver for six. For this visit, there was one resident under hospice care. About 2:00 PM, LPA Marin was granted entry after completing the Coronavirus 2019 (COVID 19) screening procedure. LPA toured the interior and exterior portions of the facility. LPA observed six residents in care and two staff members on the floor. There were 4 private and 1 shared 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. Bathrooms were observed to be in good repair; and provided with handrails and non skid floor mats. 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. For the exterior portion, facility had outside furniture in good repair. Side exit doors were self-latching; and self-latching. LPA Marin reviewed the COVID 19 mitigation plan of the facility. For this visit, the facility was observed to be in substantial compliance with Title 22 Division 6 of the California Code of Regulations. LPA Marin advised AD Mark Mendez to use general office email to send all reports: CCLASCPOrangeCountyRO@dss.ca.gov LPA Marin conducted an exit interview with AD Mark Mendez and copy of this report was left in the facility.