Routine inspection·July 7, 2022

Licensing Program Analyst(LP A) Victoria Brown arrived unannounced to conduct a Required - Annual visit on 7/7/22 at 8:15am. Administrator Certificate expires 11/25/23 for Paul Cimino. LPA met with Coreen Tigley and discussed the purpose of the visit. The facility is licensed for a capacity of 78 Non ambulatory residents. Facility has a hospice waiver for 10 to receive hospice care services. There is 0 resident receiving hospice services at this time. LPA toured and inspected the physical plant inside and outside to ensure there are no safety hazards to residents. LPA observed and interviewed a random amount of residents who were engaged in activities and others finishing breakfast during this visit. Breakfast consisted of toast, sausage, eggs, juice, hot cereal, and fruit. LPA observed 2-day perishables and 7-day non-perishables. The temperature inside the facility was observed to be at 75*F which is within the required range of 68-85*F. The hot water temperature was measured at 117.7*F which is within the required range of 105-120*F. LPA observed a pull alarm system, fire extinguisher(s), smoke and carbon monoxide detectors, and central heating and air in the facility. LPA observed the centrally stored medications area to be locked and inaccessible to residents. The first aid kit contained the required items such as sterile dressings, bandages, adhesive tape, scissors, tweezers, thermometers, antiseptic solution and guide. Upon a file review the following items were discussed to be submitted with any changes annually: Designation of Facility Responsibility (LIC308) Liability Insurance Administrator Certificate-Updated Personnel Report (LIC500) Per the California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies observed or cited. Exit interview held, copy of report given.