Routine inspection·February 22, 2022

On 2-22-22 at 2:32pm, LPA Michael Bilger arrived at this facility unannounced to conduct an annual inspection visit. LPA met with the administrator Corina and explained the purpose of the visit. LPA conducted COVID-19 questioniere prior to entry and inspection. LPA donned PPE during visit as a precaution. 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 3. LPA also conducted the infection control domain tool. The facility has an approved COVID Mitigation plan LIC 808 form in place. 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 107.2*F in the bathroom and room temperature reads 76*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 7-14-21. Facility has an emergency food and water kit. Four staff member charts were reviewed. First aid certifications reviewed. Staff4 (S4) first aid certification was observed to be expired. All COVID-19 vaccination current. One staff has an exemption in place for COVID-19 vaccination. All fingerprint clearances in place. Per California Code of Regulations, Title 22, deficiencies were observed during this visit. Exit interview was held with Corina Dragnea and a copy of this report was given to Corina. Appeal rights provided.