Routine inspection·May 26, 2021

Licensing Program Manager (LPM) Rebecca Hedgecock and Licensing Program Analyst Dang Nguyen conducted an unannounced Required 1 - Year Visit. The facility file was reviewed prior to the visit. LPM and LPA met with and were allowed entry by caregiver Milagraos Caganap and we discussed the purpose of the visit. Licensee Leonor Carmona arrived during the visit. All staff present have a current criminal record clearance. LPM and LPA conducted a tour of the facility, both inside and outside and observed the residents in care. In accordance with the Department’s Infection Control, LPM and LPA provided technical assistance, evaluated, and observed the facility's implementation of their mitigation plan to include disinfection, testing surveillance, and screening protocols as well as the use of personal protective equipment. No deficiencies were cited on this date. An exit interview was conducted with the licensee, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 01/16) were provided via E-mail. A reply E-mail or read receipt confirmation was requested from the licensee upon receipt of documents. The following forms are to be submitted on an annual basis to licensing office: Personnel Report LIC 500 and Emergency Disaster Plan LIC 610-E. Forms are available at www.ccld.ca.gov .