Routine inspection·October 28, 2022

Licensing Program Analyst (LPA) Rayshaun Nickolas conducted 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 arrived and met with caregiver Anelit Mayores and explained the purpose of the visit. LPA was asked to sign-in upon arrival. The administrator Teresa Datuin was called by Mayores and Datuin arrived at the facility at 10:45 a.m. During the inspection, LPA conducted a tour of the facility and made observations pertaining to the facility's infection control measures and other health and safety concerns. The facility has three (3) separate building also referred to as ranch 1, ranch 2, and ranch 3 by staff. The facility has five (5) clients in care in ranch 1, nine (9) clients in care in ranch 2, and one (1) client in care in ranch 3. The facility was equipped with sufficient hand hygiene supplies, sufficient cleaning/disinfecting provisions, and a supply of Personal Protective Equipment (PPE). LPA observed facility staff wearing face coverings. 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 facility's infection control measures. The facility has a plan in place which follows Community Care Licensing Division (CCLD) guidelines for COVID-19 testing, isolating/quarantining residents, and properly caring for clients with COVID-19 positive results and/or exposures. The facility also has a plan in place to monitor clients regularly for any changes in condition and to subsequently notify the client's physician and emergency personnel in the event the client presents any COVID-19 symptoms. LPA reviewed staff and clients records. LPA was greet by an individual that was volunteering at the facility without the criminal records clearance. Per volunteer # 1 (V1), V1 is a neighbor and retired nursing assistant who has been helping out at the facility since COVID-19 and offered to assist LPA during today's inspection. LPA interview with the administrator revealed that V1 does maintenance around the facility but provides no patient care. LPA observed client # 1 (C1) in ranch 3 with no care providers. LPA interview with staff # 1 (S1) revealed that C1 is the only client in ranch 3. S1 states that there is staff staying in ranch 3 with C1 at night but no one there during the time of our tour, as all other staff were in the other two (2) building. Per S1, ranch 3 does not have an call system to hear the client while staff are away; however, facility staff checks on C1 every 30 minutes LPA also observed during facility file reviews, that C2 has not had a documentation of a medical assessment, signed by a physician, made within the last year. A civil penalty in the amount of $500.00 has been assessed for V1 volunteering without a criminal records clearance. Based on observations made during today’s inspection, three (3) deficiency were cited per Title 22, Division 6, of the California Code of Regulations (CCR). An exit interview was conducted and a copy of this report, LIC 809D, LIC421BG, and Appeal Rights were given to the Administrator.