Routine inspection·June 9, 2022

Licensing Program Analyst (LPA) Ryan Gardner made an unannounced visit to the facility. The purpose of the visit was to conduct a required annual inspection, with an emphasis on infection control due to the COVID-19 pandemic. LPA Gardner met with Caretaker Rafael Colorina who confirmed that there are currently no cases and or exposures of COVID-19 within the facility. At the time of visit there were two (2) staff and five (5) residents present. LPA Gardner toured the facility inside and out and went over COVID-19 best practices for infection control and prevention with Rafael Colorina. LPA Gardner observed all staff members with a properly fitted face covering. The facility has a plan in place which follows Community Care Licensing Division guidelines for COVID-19 testing, isolating/quarantining residents, and properly caring for residents with COVID-19 positive results and/or exposures. The facility has a designated infection control lead person who has been tasked with tracking all COVID-19 cases and/or suspected cases, ensuring PPE supplies are maintained, cleaning and disinfection provisions are in adequate quantities, and that staff are trained in the proper use and disposal of PPE. The residents have hand sanitizer available to them throughout the facility and the bathrooms were stocked with hand soap and paper towels. LPA Gardner observed the facility to have multiple postings throughout the facility for cough etiquette, proper hand washing procedure, and social distancing. LPA Gardner requested to inspect the facility's Personal Protective Equipment (PPE) supply, which was located in the staff closet. The facility has a full thirty (30) day supply of PPE items such as gloves, face shields, gowns, N95 masks, disinfectant, and hand sanitizer. All residents and staff are practicing all other COVID-19 precautions, which minimize the risk of them contracting COVID-19. During today’s visit, LPA Gardner observed pre-prepped medications that were placed in an alternative containers than the original containers received from the pharmacy. The medications were not stored in the original received containers from the pharmacy which poses an immediate health, safety, or personal rights risk to persons in care. During today’s visit, LPA Gardner observed unlocked medications in the refrigerator. The medications were not in a lock box in the refrigerator which poses an immediate health, safety, or personal rights risk to persons in care. Based on the observations made during today’s visit, two (2) deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report was discussed and provided to Caretaker Rafael Colorina, along with copies of the LIC-809D forms, and the appeal rights.