Routine inspection·October 6, 2021

On 10-6-21 Licensing Program Analyst (LPA)s Tirzah Hubbard and Christina Valerio arrived unannounced to conduct a Required – 1 Year inspection. LPAs contacted the facility to ask follow up questions in regard to Covid-19. LPAs spoke with the Licensee Jinky Paran to ask follow up questions for Covid-19 symptoms. LPAs proceeded to approach the facility to conduct the Annual after the facility was cleared. All required COVID measures were observed. LPAs observed S1 and Administrator wearing mask upon entry. S1 took the temperature of LPAs and asked Covid-19 screening questions. LPAs were allowed entry into the facility that is licensed to serve a total capacity of 4 clients. LPAs interacted with a random number of residents during this visit. The physical plant was toured inside and outside to ensure the safety of the residents. All required furniture were observed. LPAs observed residents engaging in activity, wearing a mask and practicing social distancing. LPAs observed the facility conducts fire drills monthly. All bedrooms contained a dresser, bed, and night stand. The flooring of the facility is a good condition. LPAs observed the thermostat temperature inside the facility hallway was measured at 74 *F which is within the required range of 68 degrees F (20 degrees C) and 85 degrees F (30 degrees C), or in areas of extreme heat the maximum shall be 30 degrees F (16.6 degrees C) less than the outside temperature. The hot water was measured at 106 *F which is not less than 105 degrees F (40.5 degrees C) and not more than 120 degrees F (48.8 degrees C) as per Title 22 regulations. LPAs observed the centrally stored medications area to be locked and inaccessible to clients. LPAs observed 3 of 3 medications counted properly labeled and stored, matching medication administration records (MAR). The first aid kit was found in compliance containing at least the following: a current edition of a first aid manual approved by the American Red Cross, the American Medical Association or a state or federal health agency, sterile first aid dressings, bandages or roller bandages, adhesive tape, scissors, tweezers, thermometers, and Antiseptic solution. LPAs observed a pull alarm system, fire extinguisher(s), smoke and carbon monoxide detectors, central heating and air in the facility. LPAs observed there were food supplies of staple nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days which shall be maintained on the premises at all times. LPAs observed the backyard area in good condition. The facility was clean and organized. LPAs observed two window screens needing replacement and provided technical assistance. Licensee showed proof of order for new window screens and will replace the window screens on 10-12-21. Licensee will send proof of replacement through email to LPA Hubbard. Mitigation Plan was submitted and approved. Upon a file review the following items were discussed to be submitted with any changes annually: Criminal Record Clearances LIC508 Administrative Organization LIC309 Designation of Administrative Responsibility LIC308 Personnel Report LIC500 Qualifications of Administrator/Facility Manager- Administrator certificate Emergency Disaster Plan LIC610D Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 6, there were no deficiencies cited during this visit. Exit interview held and a copy of report was provided in email for signature from licensee and copies faxed and emailed back.