Routine inspection·October 7, 2022

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual. LPA met with Danielle Fabyunkey Lawrence, caregiver and explained purpose of inspection. LPA met with Anita Heydon, Administrator who arrived at 11:15 am and spoke to Licensee by phone regarding newly converted resident room. Also, House Manager, Ram Pratap, arrived also at 11:15 am from grocery shopping. LPA observed (2) residents in the common area and (2) residents to be in their rooms at the start of the inspection. The facility is currently licensed for (5) non-ambulatory residents; however, was approved on 9/23/2022 by the fire department for (6) residents- (2) ambulatory (rm #1- newly converted room, currently vacant) and (4) non-ambulatory residents. Currently there are (0) residents receiving hospice services. Prior to initiating today's inspection, LPA completed required COVID-19 testing protocols and was screened per Covid-19 precautionary measures upon entering the facility. and was wearing a surgical mask. LPA and Administrator toured the interior/exterior of the facility including common areas, resident bedrooms (5), resident bathrooms (2), kitchen, and laundry area/garage. LPA observed the facility to be clean, in good repair and odor-free, and the bathrooms to have grab bars, non-skid flooring, paper towels and 20-second hand-washing posters. LPA observed sufficient 2+day perishable and 7+day non-perishable supply of food. LPA observed multiple toxins to be unlocked below the kitchen sink and the drawer containing sharps to be currently unlocked. LPA observed medications, including those needing refrigeration, to be secured nearby. LPA observed the inside temperature to be 76*F. Fire extinguisher last serviced 6/6/2022. Discussed vaccination status of residents/staff, boosters and visitation protocols- booster flyer provided. LPA observed multiple Covid posters throughout and other required postings. LPA observed (1) unlocked gate from the inside back patio.LPA observed sufficient incontinent products and PPE. LPA requested an updated copy of LIC500, LIC308, LIC200 and current liability insurance be provided to the Depart by 10/14/22. Per California Code of Regulations, Title 22, Division 6, Chapter, 8, the following (1) deficiency is cited on the 809D page. Exit interview. Copy of report and appeal rights provided.