Routine inspection·November 4, 2022

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual. LPA met with Alex Molitvenik, Administrator, and explained purpose of inspection. LPA observed (2) residents to be in the common areas and (3) residents to be in their rooms at the start of the inspection. Currently, there are (0) residents on hospice. The facility is licensed for (6) non-ambulatory residents. Prior to initiating today's inspection, LPA completed required COVID-19 protocols. LPA was screened per Covid-19 precautionary measures upon entering the facility, and LPA was wearing a surgical mask. LPA and Administrator toured the interior and exterior of the facility including the common areas, (5) resident bedrooms, (2) full bathrooms, kitchen, staff room and locked laundry area. LPA observed the facility to be clean, in good repair and odor-free. LPA observed the bathrooms to have the necessary grab bars, non-skid flooring, and paper towels - Administrator agrees to post 20-second hand-washing posters at each bathroom and kitchen sink. LPA observed sufficient 2+day perishable and 7+day non-perishable supply of food. LPA observed the sharps to be unsecured in the kitchen and some medications to be unsecured in resident (R1's) room and in a cabinet near the kitchen. LPA and Administrator discussed vaccination status of residents/staff, eligibility for boosters. LPA observed a few Covid posters throughout as well as other required postings. LPA observed (1) unlocked gate from the inside back patio with covered patio seating. There are no pools or bodies of water. All exit doors have alarms. LPA reviewed (2) staff files and found them to contain current training documentation, including First Aid/CPR. All staff are fingerprint cleared/associated. LPA reviewed (3) resident files and found them to be missing care plans. LPA requested an updated copy of LIC500, LIC308, and current liability insurance be provided by 11/14/2022. Per California Code of Regulations, Title 22, Division 6, Chapter 8, the following (2) deficiencies are cited on the 809-D page. Exit interview with Administrator. Copy of report and appeal rights provided.