Routine inspection·September 2, 2022

Licensing Program Analyst (LPA), Janira Arreola made an unannounced visit to the facility to conduct an annual inspection focused on infection control. LPA met with staff, Rose De los Santos, who was informed of the purpose of the visit. At the time of visit there was 2 staff and 5 residents present. The facility currently has zero positive or suspected Covid-19 cases. During today's visit, LPA toured the facility and made observations regarding the infection control measures that the facility has implemented. LPA observed Covid-19 postings at the facility and a single entry point was designated where symptoms screenings and temperature checks occur daily for all visitors, residents, and staff. The facility had an adequate amount of hand hygiene supplies (soap, hand sanitizer, paper towels) in all restrooms. Common areas such as dining rooms and activity rooms have been modified with social distancing and masking policies. There are designated isolation rooms and a plan in place to monitor and attend to those in the isolation rooms. LPA observed a sufficient 30-day supply of PPE equipment. LPA observed facility mitigation plan LIC808 had been approved and submitted to the department. LPA observed the following technical violations: LPA review (2) out of (5) resident records and found PCP information had not been updated. Staff have not been N95 Fit Tested LPA will document this on LIC9102 TV pages. LPA along with facility staff noticed the following deficiencies: Unlocked knifes in kitchen were accessible to resident, as well as unlocked disinfectant in resident restroom. LPA observed kitchen had a door in the frame with a lock. Facility does not have a current waiver on file for this, per facility administrator Zoraida Margate. There was no staffing schedule that was provided to LPA at the time of the visit. Therefore, LPA could not verify proper staffing and coverage at the facility. LPA observed PRN medication in R1's room. Per staff, PRN and vitamins are longer being taken by the resident. LPA reviewed R1's file and found that per physican's report, R1 is not able to store their own medication. Deficiencies were documented along with Plan of Correction on LIC809-D pages. An exit interview was conducted, where a copy of this report, along with 809-D pages, LIC9102TV, and appeal rights were reviewed and provided to facility staff, Rose De los Santos.