Routine inspection·December 30, 2022

Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility on 12/30/2022 to conduct an annual inspection. LPA met with caregiver, Alfred Flores, and explained the purpose of the visit. Caregiver contacted Administrator who is informed LPA she is currently stuck in traffic. Prior to entering the facility, LPA ensure she applied hand sanitizer and the following Personal Protective Equipment was worn: surgical mask. At entrance, LPA was screened for COVID-19 symptoms. LPA was informed there are currently five (5) residents in the facility with one (1) on hospice services. LPA reviewed facility license and confirmed there is a hospice waiver of 5. LPA and caregiver toured the interior of the facility to ensure the health and safety of residents in care. In areas toured no immediate health, safety and personal rights violation were observed. LPA observed (4) residents present in their private rooms, and (1) resident in the common area watching television. LPA observed the pantry to have at least 7+ days of non-perishable foods for the residents in care, and observed caregiver to be preparing rotisserie chicken for dinner. LPA observed medications, sharps and toxics to be locked and secured. LPA observed a bottle of Clorox spray present in the laundry room but was informed by caregiver it is empty and not secured as it needs to be thrown away. LPA requested a copy of Administrator Certificate, liability insurance, LIC 500 and LIC 308 to be faxed or emailed to LPA by Friday, 01/06/2023. As a result of today's inspection, no deficiencies were observed. Exit interview conducted and a copy of the report was left at the facility.