Routine inspection·May 6, 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 Administrator Bienvenidaja Tandoc who confirmed that there are currently no cases/exposures of COVID-19 within the facility. At the time of visit there was four (4) staff and six (6) residents present. LPA Gardner went over COVID-19 best practices for infection control and prevention with Bienvenidaja Tandoc. The facility has a mitigation plan on file with licensing. 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, which was located in the hall closet. The facility has a full 30-day supply of PPE items such as gloves, face shields, gowns, surgical masks, N95 masks, disinfectant, and hand sanitizer. LPA Gardner inquired as to if staff have been fit tested for N95 masks and was told their staff have not 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. All residents and staff are practicing all other COVID-19 precautions, which minimize the risk of them contracting COVID-19. LPA Gardner found that staff (S1) has been at the facility for over five days without being fingerprint cleared to be in the facility. S1 congregates at the facility, helps with groceries, and helps with tasks around the facility. The facility will be issued a citation and a $500 civil penalty for allowing S1 to be at the facility without a fingerprint clearance. Based on the observations made during today’s visit, one (1) type A deficiency was 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 Bienvenidaja Tandoc, along with a copy of the TA Advisory Note, LIC809D, LIC811, and the appeal rights.