Follow-up·November 15, 2021

Licensing Program Analysts (LPA) Michael Hood arrived at the facility and met with Administrator, Nerry Rimando-Afable, to follow-up regarding information received from a previous interview conducted. Facility currently does not have any COVID-19 positive cases. LPA wore N-95 mask and was screened by facility upon entry. Facility staff wore masks in the care home. During previous interviews conducted with relevant parties, it was discovered that staff may have not reported incident to Community Care Licensing. LPA conducted interview with staff member (S1), Administrator, and received contact information for former resident (R1). At this time, further investigation is needed regarding information above. During previous interviews conducted, it was discovered that staff may be sleeping at the facility when there is not a designated staff member bedroom. LPA observed garage with bed and dresser. Administrator stated that staff had previously slept in garage but were instructed that they may no longer use the garage as a bedroom and must move their belongings. LPA observed facility sketch and found that garage was listed as "storage" and not approved as a designated staff member bedroom for staff to sleep in. Due to interviews previously conducted, documents reviewed, and LPA's observation, per California Code of Regulations, Title 22 Division 6, Chapter 8, deficiencies are being cited on the attached 809-D page due to staff sleeping at the facility when facility does not have an approved staff member bedroom. Exit interview was conducted with Administrator and a copy of this report and appeal rights were provided to the facility. The signature of the Administrator on these forms acknowledges receipt of these documents.