Routine inspection·March 25, 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. Upon entry LPA Gardner met with Caretaker Victor Vidrio who confirmed that there are currently no cases/exposures of COVID-19 within the facility. At the time of visit there were two (2) staff, and two (2) residents present. S1 spoke to LPA Gardner in broken English. S1 stated that they did not understand LPA Gardner. S1 requested that LPA Gardner speak into a cell phone on a translator application. S1 read the translator application, then spoke into the translator application to respond to LPA Gardner. LPA Gardner called the licensee and notified them they need to come to the facility to complete the visit or send another staff member who could speak to LPA Gardner with no communication issues. Licensee Na. Zhoa did not come to the facility, so LPA Gardner completed the visit with S1. The facility will be issued Technical Assistance Advisory note for not having someone at the facility capable of communicating without issues. Upon observation and interview, LPA Gardner discovered that S2 is working at the facility without having criminal background clearance. S2 has been working at the facility for one (1) year. The facility will be issued a citation for S2 not having a criminal background clearance, as well as a $500-dollar civil penalty. LPA Gardner requested to view staff files for S1, LPA Gardner was notified there was not a staff file for S1. The facility will be issued a citation for having a staff file for S1. S1 started creating a file during todays visit once LPA Gardner notified them it was needed for review. ...Continued on LIC809C... ...Continued from LIC809... Upon review LPA Gardner discovered the administrator certificate is expired. The facility will be cited for not having a valid administrator for the facility. LPA Gardner went over COVID-19 best practices for infection control and prevention with Mr. Vidrio. Residents have hand sanitizer available to them 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; Mr. Vidrio was unsure where the PPE was located in the facility. LPA Gardner was unable to verify if the facility has a 30-day supply of PPE items such as gloves, face shields, gowns, surgical masks, N95 masks, disinfectant, and hand sanitizer supply. LPA Gardner discussed obtaining a full 30-day supply of PPE, as well as creating a cart, or similar, to have a supply of PPE ready that would be dedicated for isolation room, along with a trash can to put inside and outside of an isolation room. LPA Gardner inquired as to if staff have been fit tested for N95 masks, and Mr. Vidrio was unsure if they had been fit tested yet. LPA Gardner will be issuing a Technical Assistance Advisory Note during today's inspection for staff not being fit tested for N95 masks and for not having a 30-day supply of PPE. All residents and staff are practicing all other COVID-19 precautions, which minimize the risk of them contracting COVID-19. Based on the observations made during today’s visit, three (3) 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 Mr. Vidrio, along with a copy of the TA Advisory Notes, LIC809C, LIC809Ds, LIC421BG, and appeal rights