Routine inspection·June 23, 2022

Licensing Program Analyst (LPA) Avelina Martinez and Navdeep Singh made an unannounced visit to conduct an annual inspection on 06/23/2022 at 11:30 AM. LPA met with Alicia Weathers 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 of the facility to ensure compliance with Title 22 regulations. The facility is licensed for 115 non-ambulatory residents, 55 dementia residents, 20 bedridden residents, and 21 hospices residents. There are currently 103 residents and 10 hospice residents. The LPA Martinez and Navedeep Singh toured the facility with Alicia on 06/23/2022 at 2:00 PM. The facility has one main entry COVID-19 screening area. The facility has covid-19 positing throughout the facility. The facility has hand sanitizer throughout the facility. The common area furniture is spaced 6 feet apart. The facility conducts disinfection cleaning daily. The facility was sanitary, and the facility temperature was 78 degrees. Water temperature was inspected in two residents rooms and at kitchenette on second floor. Water temperatures were as follows: 105, 108, and 115 degrees. LPA inspected fire extinguishers and last fire inspection was on 09/28/2021. The facility last fire drill was on 06/21/2022. The facility had an adequate food supply. LPA Martinez observed unlock cleaning supplies at second floor kitchenette. LPA Martinez observer a resident in the kitchenette during the time kitchen cleaning supplies were unlocked. LPA Martinez reviewed two resident files and two employee files. Two out of two resident files were up to date. One out of two staff files was not complete during file review. Staff 1 file was missing a document. The missing document information was verified, and the document was requested from primary care physician and received during the visit . A technical violation advisory was given. An exit interview was conducted, and copy of the 809 report, 809-D, appeals rights were given to the facility.