Routine inspection·November 10, 2021

Licensing Program Analyst (LPA) Carmen Lopez made an unannounced visit to the facility to conduct an annual required licensing inspection. LPA identified herself and was granted entry by Esmeralda Tores, caregiver. LPA met with Licensee Luz Velasco and discussed the purpose of today’s visit. A tour of the facility was conducted inside and out. LPA accompanied by Licensee conducted a general overall inspection, with specific focus on infection control protocols. During today's inspection LPA observations include the following: Symptom screening procedures for staff, residents and visitors; posted signs regarding visitor policy, promoting hand washing, cough and sneeze etiquette and other infection control procedures; testing plan and procedures; plans for containing infections, PPE supplies procedures and training; and disinfection procedures. Based on today’s inspection, no deficiencies were observed. An exit interview was conducted with Licensee Velasco. A copy of this report, along with the Licensee Rights (01/2016) was emailed to Licensee Velasco at the conclusion of the visit. LPA requested Licensee to send LPA an electronic message reply confirming receipt of these documents. LPA requested Licensee to submit a current Personnel Report LIC 500, Designation of Administrative Responsibility LIC 308, and an Emergency Disaster Plan LIC 610-E to the licensing office within 10 business days. Form is available at www.ccld.ca.gov .