Post-licensing visit·December 9, 2022

Licensing Program Analyst (LPA) Celine De Perio conducted an unannounced required post-licensing inspection focusing primarily on the Infection Control. LPA De Perio was greeted and granted entry by staff on duty who checked temperature prior to entering facility. During the visit, As of 12/9/22, there are 0 active COVID-19 cases in the facility as verified. LPA De Perio observed the COVID-19 precautionary signs posted throughout the facility. The PUB475 "See Something, Say Something" poster was observed at the entrance of the facility. LPA De Perio observed the Administrator's Certificate for Aurelia Olais, which expired on 11/22/22, however provided documentation to LPA De Perio that renewal application was submitted on 9/25/22, and renewal payment was submitted on 9/26/22. LPA De Perio toured the interior and exterior portions of the facility with staff on duty (S1). The facility is a two level structure, however, facility is only licensed to utilize the first floor. Facility is licensed for 38 residents 60 years and over, of which 16 may be on hospice and 16 may be bedridden. Also, facility has not been approved to have delayed egress or secure locked perimeters. Currently, there are a total census of 24 residents in care of which 6 are on hospice. Bedrooms observed were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. Most recent fire inspection took place on 7/13/22 of which was passed. The restrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Facility has a total of 19 shared bedrooms of which all have 1 shared bathroom. Water temperature in restrooms were measured at 105.4 degrees Fahrenheit. LPA De Perio also tested pull cords in random resident bathrooms, and observed it was operational. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Fire extinguishers were charged, mounted and located in the facility hallway. For the exterior portion, LPA De Perio observed patio furniture under shading, and the grounds were free of any hazards. LPA De Perio observed the emergency disaster and evacuation plan, which is posted at the entrance of the facility. Facility had back-up emergency food and water supply, located in the supply closet. LPA De Perio observed that First Aid Kit had all the required components. The facility had an adequate supply of PPE. Medications were locked in the medication room. Toxins were also observed to be locked and inaccessible to residents in care and located in the laundry room. LPA De Perio verified the Coronavirus 2019 (COVID 19) mitigation plan of the facility with AD Olias. LPA De Perio discussed Assembly Bill 665 requires that a licensee of any adult or senior care residential facility that has internet service provide at least one internet access device, such as a computer, smart phone, tablet or other device, that: can support real-time interactive applications; is equipped with video conferencing technology, including microphone and camera functions; and is dedicated for client or resident use. For today's visit deficiencies were issued per Title 22 Division 6 of the California Code of Regulations. LPA De Perio advised AD Olias to use the general email address: CCLASCPOrangeCountyRO@dss.ca.gov for any inquiries and to specify attention to the assigned LPA. LPA De Perio conducted an exit interview with AD Olias and a copy of this report was provided to the facility.