Routine inspection·May 20, 2022

Licensing Program Analysts (LPA) Claudia Gutierrez made an unannounced visit for the purpose of conducting a Required/Annual Inspection. LPA was greeted by staff David Williams and granted entry into the facility. LPA Gutierrez discussed the purpose of the inspection. During the inspection LPA Gutierrez and staff Williams conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, and observed the following: This is a single-story house with six bedrooms, and two bathrooms, with one bedroom being occupied by staff. During the inspection LPA observed two staff and four residents in care. Residents were observed resting in their respective rooms. A 2-day supply of perishable and a 7-day supply of non-perishable foods was not observed during today’s visit; a Deficiency was cited on this date. Upon record review LPA noted emergency care requirements were not met, a Deficiency was cited on this date. LPA observed the facility does not have a 30-day supply of PPE on hand; a Technical Advisory was given on this date. LPA observed hallways and walkways were free of obstruction. LPA reviewed and confirmed facility policies and practices regarding resident screening, staff screening, visitation, COVID-19 surveillance testing, COVID-19 clearance testing, quarantine, isolation, cohorting, infection control training, PPE, staffing and staffing shortages. Based on the observations made during today’s inspection, two deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report was left at the facility.