Routine inspection·May 18, 2022

Licensing Program Analyst (LPA), Janira Arreola made an unannounced visit to the facility to conduct an annual inspection focused on infection control. LPA was greeted and granted entry by S1 and met with Administrator Agnes Martinez, who was informed of the purpose of the visit. At the time of visit there was 3 staff and 6 residents present. The facility currently has zero positive or suspected Covid-19 cases. During today's visit, LPA toured the facility and made observations regarding the infection control measures that the facility has implemented. LPA observed Covid-19 postings at the facility in a COVID binder and advised Administrator to post them throughout the facility. A single entry point was designated where symptoms screenings and temperature checks occur daily for all visitors, residents, and staff. The facility had a plan in place to monitor residents regularly for any changes in condition by documenting progress notes. The facility had an adequate amount of hand hygiene supplies (soap, hand sanitizer, paper towels) in all restrooms. Common areas such as dining rooms and living rooms have been modified with social distancing and masking policies. There are designated isolation rooms and a plan in place to monitor and attend to those in the isolation rooms. LPA observed a sufficient 30-day supply of PPE equipment. The facility also has a designated infection control lead and a plan in place to clean and disinfect the highly touched surfaces. LPA advised Licensee to provide the department with a copy of the facility Mitigation plan that was previously submitted to the department on 5/20/2021. LPA requested a copy of the latest LIC9020 and was advised by Administrator that R1 had not been added to the LIC9020 dated 4/30/2022 and R1 was admitted 5/5/2022. LPA will give technical violation and Licensee was able to add resident to the LIC9020 by the end of the visit. During the tour LPA noticed Clorox wipes on the counter of R2’s bathroom. Per LIC9020 R2 is no ambulatory. LPA will give technical violation for this and S1 was able to remove the Clorox wipes right away. There were no deficiencies noted at the time of the visit. An exit interview was conducted, and a copy of this report was reviewed and provided to facility Adminsitrator, Agnes Martinez.