Routine inspection·October 17, 2023

Licensing Program Analyst (LPA) Jamie Ivey Canady made an unannounced visit to this facility to conduct an annual inspection. LPA met with Nazarina Vera and stated the purpose of today’s visit. LPA inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, activity room, and outside courtyards of the facility to ensure compliance with Title 22 regulations. Administrator certificate 6027605740 expired on 8/7/2023. Administrator applied for new certificate 7/1/2023. The facility is licensed for six non-ambulatory residents. There are currently 6 residents who reside at this facility, and the facility has an approved hospice waiver for 6. LPA Ivey Canady toured the facility with Nazarina Vera. LPA requested and reviewed 2 staff and 2 personnel files during today's visit. The facility has submitted a Covid-19 mitigation plan and Infection Control plan. The facility has one main screening entry point, and conducts daily staff, visitors, and resident screening checks. The fire extinguisher 7/2024, smoke detectors, and carbon detectors are in good repair. The facility has a first aid kit and medications are stored in a locked cabinet. The facility has an adequate supply of food, and the kitchen was sanitary. The resident bedrooms were furnished and in good repair. The exterior of the facility is clear of debris, and the emergency exit gate is in good repair. The facility is in compliance with California Code of Regulations, Title 22 and Health and Safety Code, there were no deficiencies cited at this time. An exit interview was held, and a copy of this report was emailed to administrator due to printer malfunction.