Routine inspection·July 15, 2022

Licensing Program Analyst (LPA) Michael Hood arrived at the facility unannounced on 7/15/2022 to conduct a Required-1 Year Inspection utilizing the infection control domain. LPA met with Administrator, Chris Butts, and explained the purpose of the visit. Prior to initiating the annual inspection, LPA completed required COVID-19 testing protocols and the daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPA ensured to apply hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N-95 Mask. LPA toured the facility to ensure the health and safety of the residents in care. Areas toured include but are not limited to: 4 bedrooms and 2 bathrooms for residents, common area, dining room, food supply, office, and outdoor area. LPA and Administrator completed the infection control domain. Upon entry of the facility, LPA observed cleaning solutions and knives unlocked and accessible to residents in care. LPA also observed multiple food items that were expired and missing labels. As a result of today's inspection, deficiencies are cited pursuant to California Code of Regulations, Title 22, Section 87309(a) regarding unlocked chemicals and knives, and Section 87555(b)(8) regarding expired and unlabeled food items. Deficiencies are listed on 809-D. Exit interview was conducted with Administrator. A copy of this report and appeal rights were provided. The Administrator’s signature on these forms acknowledges receipt of these documents.