Routine inspection·October 7, 2022

On 10/07/2022 at 1:50 pm, Licensing Program Analyst (LPA) Tung Truong arrived at this facility unannounced to conduct an annual inspection visit. Prior to entering the facility, LPA Truong called the facility and spoke to staff who confirmed no residents or staff have had any symptoms of COVID-19 in the last 10 days. LPA met with Administrator Renee Ates explained the purpose of the visit. Administrator holds current certification #6021935740 and expires on 9/20/2022. Administrator stated her renewal application was submitted early September. The facility is licensed to serve six (6) non-ambulatory residents. Hospice waiver approved for 2. There are currently four (4) residents who reside at this facility. LPA toured the facility with Renee Ates on 10/07/2022 at 2:10 pm. LPA inspected the physical plant including but not limited to the common area, kitchen, dining area, resident bedrooms, resident bathrooms, laundry area, and outside courtyards of the facility to ensure compliance with Title 22 regulations. LPA observed the facility is clean and in good repair. LPA observed sufficient furniture and lighting throughout the facility. LPA observed bedrooms to be properly furnished, with appropriate bedding and lighting. The bathrooms were in sanitary condition and properly maintained. The hot water temperature was observed to be 112.0 degrees Fahrenheit, which is within the required regulation of 105 to 120 degrees Fahrenheit. Facility thermostat observed at 75 degrees Fahrenheit. Food supply is adequate for 2-day perishable and 7-day nonperishable. Continued on 809-C LPA observed knives were locked away and inaccessible to clients. Smoke and carbon detectors were in good repair. Fire extinguisher and first aid kit was up to date. LPA checked medication storage and found medication to be locked away and inaccessible to clients. LPA observed toxins were not locked and accessible to residents. LPA also conducted the infection control domain tool. The facility mitigation plan was submitted to CCLD, and it was approved on 4/27/2021. Facility has routine symptom screening checks for residents, staff, and visitors. The facility has a symptom check binder for staff, residents, and care staff. Hand Hygiene procedures have been implemented. Facility had Covid-19 posters throughout the facility, and the facility has implemented Covid-19 mitigation plan. Per California Code of Regulations, Title 22, deficiencies were observed and cited on the 809-D during this visit. Exit interview was held, a copy of the report and appeal rights was provided.