Routine inspection·August 23, 2021

On 8/23/21 at 3:01pm, Licensing Program Analyst (LPA) Michael Bilger arrived at this facility unannounced to conduct an annual inspection visit. LPA was greeted by facility manager Mariza Eva and explained the purpose of the visit. Administrator Lani Calagui was not present and gave permission via phone call for Mariza Eva to accompany LPA and sign on her behalf. LPA Bilger inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, living area, common TV area, and outside backyard of the facility to ensure compliance with Title 22 regulations. Facility is a 6 bed facility with a current census of 6. LPA also conducted the infection control domain tool. Facility has 4 bedrooms. All resident rooms are shared. There is a separate room for staff use only. Facility has 2 bathrooms and a formal dining area and separate living and TV room. All resident rooms are located down one hallway. No obstructions to emergency exits notied. All sharps and toxins are secured and inaccessible to residents in care. The facility submitted a LIC 808 mitigation plan, which was approved. The facility has central entry point and has implemented screening and sign in procedures at the front door area. The facility conducts routine symptom screening for employees, residents, and visitors. LPA observed the facility to have hand washing, COVID - 19 informational, and social distancing signs posted throughout the facility, on the front door, and back yard. The facility has a designated infection control lead. The facility is able to designate and dedicated a Covid-19 room/bathroom if needed. Common touch surfaces are cleaned after each use. Water temperature reads 114.2*F in the bathroom and room temperature reads 78*F. LPA observed the facility to have adequate food supply. Resident rooms were sanitary and had the required furniture and furnishings. The facility common areas were clean and furnished. Smoke and carbon detectors were in good repair. Fire extinguisher was checked 7/1/21. Facility has an emergency food and water kit. Per California Code of Regulations, Title 22, no deficiencies were observed during this visit. Exit interview was held and a report was given to Facility Manager Mariza Eva