Routine inspection·August 5, 2021

Licensing Program Analyst (LPA) Melana Llopis arrived at the facility unannounced on 08/05/2021 to conduct a Required 1 - year annual inspection. Prior to visit LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; contacted licensee and completed a facility risk assessment. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical Mask. Additionally, LPA was screened by Denise Hall, staff, upon entering the facility. Staff, Audrey Whittaker contacted Administrator and made him aware of LPA's presence and purpose of the visit. Administrator appointed staff (S2) to tour with LPA due to their absence. LPA toured the facility with S2, areas inspected include but are not limited to the following: facility living room, dining room, kitchen, backyard, garage, laundry room, resident bedrooms and bathrooms. LPA observed the facility to be clean, odor free and in good repair. LPA observed knives, cleaning supplies and medications locked and inaccessible to residents in care. LPA observed a sufficient supply of 7 day nonperishable food items and 2 day perishable food items. LPA observed an adequate supply of PPE. LPA found the fire extinguisher to be last serviced on 1/1/2021 and fully charged. LPA found resident bedrooms to have required furniture and sufficient lighting. LPA found the bathrooms to have required grab bars and nonskid shower surface. LPA measured the water temperature to be 105.5 degrees F. S2 tested the smoke detectors and carbon monoxide device and LPA observed both to be in working order. First aid kit was found to be complete. LPA observed one (1) resident in care to be using oxygen but did not find an "oxygen in use" sign posted. LPA reviewed a sample of one (1) resident record and was found to be current and complete. LPA reviewed two (2) hospice care plans for two (2) residents in care receiving hospice services. Hospice care plans were found to be sufficient. LPA reviewed two (2) staff files and found staff files to be current and complete. LPA conducted a medication audit for one (1) resident and found no errors. As a result of today's visit, a deficiency is being cited and can be found on LIC 809-D, per California code of regulations, title 22. Exit interview conducted, copy of report and appeal rights provided.