Routine inspection·July 29, 2021

Licensing Program Analyst (LPA) Avelina Martinez made an unannounced visit to this facility to conduct an annual inspection on 07/29/2021 at 1:05 PM. LPA met with Harue Seki and Hidenori Seki and stated the purpose of today’s visit. LPA inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, activity room, and outside courtyards of the facility to ensure compliance with Title 22 regulations. The facility is licensed for six non-ambulatory residents. There are currently 6 residents who reside at this facility. The facility has a hospice waiver for three residents, which there are no residents receiving hospice services. LPA Martinez toured the facility with Harue Seki and Hidenori Seki on 07/29/2021 at 2:20 PM. LPA Martinez reviewed three employee files and three resident files. The employee and resident files are up to date. LPA Martinez reviewed 2 medication files. The medication files are up to date. The facility is furnished and sanitary. The facility smoke/carbon detectors are in good repair. The facility fire extinguisher was last inspected in March of 2021. he facility has a 2 day perishable and 7 day non-perishable food supply.The facility submitted a LIC 808 mitigation plan. The mitigation was approved. The facility has Covid-19 postings throughout the facility. The facility one central screen area. There were no deficiencies observed at this annual inspection. LPA Martinez conducted an exit interview with Harue Seki, and a copy of this report was given to Hidenori Seki.