Routine inspection·November 9, 2021

Licensing Program Analyst (LPA) Christina Valerio arrived at this facility unannounced to conduct an annual inspection visit. LPA Valerio introduced herself, explained the purpose of the visit, and was met by Administrator Okgi Min. LPA Valerio was screened for COVID-19 symptoms with temperature prior to being allowed inside the facility. Staff confirmed residents and staff have not displayed any signs or symptoms of COVID-19 in the last 10 days. The physical plant was toured inside and outside to ensure the safety of the residents and compliance with Title 22 regulations. LPA also conducted the infection control domain tool. The facility has an approved LIC 808 mitigation plan uploaded into FAS. LPA observed the facility to have COVID-19 informational signs, social distancing signs, hand washing signs posted throughout the facility. The facility is able to designated and dedicated a Covid-19 bedroom, bathroom, and isolation area if needed. Facility has 30 day supply of PPE. LPA observed the temperature inside the facility was measured at 75 *F, which is within the required range of 68 degrees F and 85 degrees F. The hot water was measured at 106.8 *F, which is not less than 105 degrees F (40.5 degrees C) and not more than 120 degrees F (48.8 degrees C). Facility has nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days. Emergency supply of food and water were observed.The centrally stored medication area and cleaning supplies observed to be locked. Resident rooms observed to be sanitary with required furniture and furnishings. The facility common areas were clean and furnished. Pull alarm, smoke, carbon detectors were in good repair. Fire extinguishers is up to date with last check on 08/18/2021. All emergency exits were clear from obstructions. LPA obtained copies of facility documentation: LIC 500, Liability Insurance, LIC 308, LIC 9020A, and LIC 601E Per California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies were observed during this visit. An exit interview was held, and a copy of the report was left with Administrator Okgi Min.